Key result
Isolation of arrhythmogenic pulmonary veins yielded similar 12-month sinus rhythm success rates compared to all-vein isolation (53% vs 59%, P=0.51), with reduced radiofrequency and fluoroscopy.
Why the study?
Does isolation of only arrhythmogenic pulmonary veins maintain similar efficacy and improve procedural metrics compared to standard isolation of all pulmonary veins in patients with paroxysmal atrial fibrillation?
Population
207 patients with paroxysmal atrial fibrillation (PAF)
Comparison
Isolation of only arrhythmogenic pulmonary veins… vs Standard isolation of all pulmonary veins
Design
RCT, Randomized (specific method not stated)
Follow-up
12 months
Authors
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Selective aPV isolation may shorten procedures and reduce proarrhythmic effects in PAF; leaves open comparable efficacy versus all-PV isolation.
RCT (n=207)
randomized
Does isolation of only arrhythmogenic pulmonary veins maintain similar efficacy and improve procedural metrics compared to standard isolation of all pulmonary veins in patients with paroxysmal atrial fibrillation?
Absolute Event Rate: 53% vs 59%
p-value: p=0.51
Targeted isolation of only arrhythmogenic pulmonary veins yields similar 12-month rhythm control to standard all-vein isolation in paroxysmal AF, while reducing radiofrequency applications and fluoroscopy time.
Fichtner et al. (2013) conducted an RCT in paroxysmal atrial fibrillation (n=207). Isolation of the arrhythmogenic vein (aPV) vs. Isolation of all pulmonary veins was evaluated on Sinus rhythm off antiarrhythmic medication 12 months after a single procedure (p=0.51). Isolation of arrhythmogenic pulmonary veins yielded similar 12-month sinus rhythm success rates compared to all-vein isolation (53% vs 59%, P=0.51), with reduced radiofrequency and fluoroscopy.
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