Artificial intelligence for individualized treatment of persistent atrial fibrillation: a randomized controlled trial
Why the study?
Although PVI is the cornerstone ablation procedure for AF, the optimal ablation strategy for persistent and long-standing persistent AF remains elusive, with AI-guided targeting of spatio-temporal dispersion suggested as a tailored alternative.
Does AI-guided tailored ablation targeting spatio-temporal dispersion in addition to PVI improve freedom from AF in patients with drug-refractory persistent AF?
Population
Patients with drug-refractory persistent AF (n = 187 tailored arm, n = 183 anatomical arm)
Comparison
AI-detected spatio-temporal dispersion ablation plus PVI vs conventional PVI alone
Design
Multicenter, randomized, controlled, double-blind, superiority trial
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Supports AI-guided tailored ablation plus PVI for persistent AF; confirms RCT superiority of dispersion targeting over anatomical PVI.
Structured PICO
Does AI-guided tailored ablation targeting spatio-temporal dispersion in addition to PVI improve freedom from AF in patients with drug-refractory persistent AF?
P
Population
370 patients with drug-refractory persistent and long-standing persistent atrial fibrillation (tailored arm n=187, 23% women; anatomical arm n=183, 19% women).
I
Intervention
Tailored ablation procedure targeting areas of spatio-temporal dispersion detected by an artificial intelligence (AI) algorithm, in addition to pulmonary vein isolation (PVI).
C
Comparator
Conventional pulmonary vein isolation (PVI)-only procedure.
O
Outcome
Freedom from documented AF with or without antiarrhythmic drugs at 12 months after a single ablation procedure.
AI-guided ablation of spatio-temporal dispersion areas in addition to PVI is superior to PVI alone in eliminating AF at 1-year follow-up in patients with persistent AF.
Cite This Study
Deisenhofer et al. (2025) studied this question.