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August 29, 2023Journal of the American Heart AssociationOpen Access

Long‐Term Impact of Additional Ablation After Pulmonary Vein Isolation: Results From EARNEST‐PVI Trial

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Why the study?

An optimal strategy for left atrial ablation in addition to pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation had not been determined.

Does additional left atrial ablation after pulmonary vein isolation reduce the recurrence of atrial fibrillation or atrial tachycardia in patients with persistent atrial fibrillation?

Population

Patients with persistent AF (n=248 in PVI-alone, n=248 in PVI-plus)

Comparison

PVI-plus strategy vs PVI-alone strategy

Design

Extended follow-up of a multicenter randomized controlled trial

Follow-up

3 years after enrollment

Authors

MMMasaharu MasudaKIKoichi InoueNTNobuaki Tanaka

Discussion

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Member takes

Overview

Additional ablation beyond PVI may lower 3-year recurrence in persistent AF; leaves open optimal lesion sets and iatrogenic AT risks.

Structured PICO

Does additional left atrial ablation after pulmonary vein isolation reduce the recurrence of atrial fibrillation or atrial tachycardia in patients with persistent atrial fibrillation?

P
Population
496 patients with persistent atrial fibrillation
I
Intervention
Pulmonary vein isolation (PVI) followed by left atrial additional ablation (including linear ablation or ablation targeting areas with complex fractionated electrograms)
C
Comparator
Pulmonary vein isolation (PVI) alone
O
Outcome
Recurrence rate of atrial fibrillation (AF) or atrial tachycardia (AT) at 3 yearscomposite

Additional left atrial ablation, specifically linear ablation, after PVI reduces long-term AF/AT recurrence in persistent AF but may increase the risk of iatrogenic atrial tachycardias.

Cite This Study

Masuda et al. (2023) studied this question.

synapsesocial.com/papers/6a9286920b68d46265a288efhttps://doi.org/10.1161/jaha.123.029651
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