Why the study?
Due to high AF recurrence rates after PVI alone in persistent AF, the optimum complementary ablation strategy in addition to PVI is unknown.
Does pulmonary vein isolation plus linear ablation improve freedom from atrial fibrillation recurrence compared to pulmonary vein isolation plus CFAE ablation in patients with persistent atrial fibrillation?
Population
92 patients with persistent AF
Comparison
PVI plus complex fractionated electrograms ablation vs PVI plus additional linear ablation
Design
Prospective randomized trial
Follow-up
Five years (mean 59±36 months)
Key result
Pulmonary vein isolation plus linear ablation did not significantly improve long-term freedom from atrial fibrillation compared to pulmonary vein isolation plus CFAE ablation (48.3% vs 44.6%, HR 1.34, p=0.412).
Loading...
Neither strategy superior; confirms equivalent modest long-term efficacy of linear versus CFAE ablation added to PVI.
RCT (n=92)
Open-label
1:1
No
Does pulmonary vein isolation plus linear ablation improve freedom from atrial fibrillation recurrence compared to pulmonary vein isolation plus CFAE ablation in patients with persistent atrial fibrillation?
Hazard Ratio: 1.34 (95% CI 0.666–2.695)
Absolute Event Rate: 48.3% vs 44.6%
p-value: p=0.412
In patients with persistent atrial fibrillation, adding either linear ablation or CFAE ablation to pulmonary vein isolation results in similar, modest long-term freedom from atrial fibrillation.
A 2020 study conducted an RCT in Persistent Atrial Fibrillation (n=92). Pulmonary vein isolation plus linear ablation vs. Pulmonary vein isolation plus complex fractionated atrial electrograms (CFAE) ablation was evaluated on Freedom from any documented recurrence of atrial fibrillation after a single ablation procedure (HR 1.34, 95% CI 0.666-2.695, p=0.412). Pulmonary vein isolation plus linear ablation did not significantly improve long-term freedom from atrial fibrillation compared to pulmonary vein isolation plus CFAE ablation (48.3% vs 44.6%, HR 1.34, p=0.412).