Pulmonary-vein isolation alone achieved 59% freedom from recurrent atrial fibrillation compared to 49% for isolation plus complex electrograms and 46% for isolation plus linear ablation after 18 months, with no significant differences among groups (P=0.15).
RCT
1:4:4
Yes
Does linear ablation or ablation of complex fractionated electrograms in addition to pulmonary-vein isolation reduce the rate of recurrent atrial fibrillation in patients with persistent atrial fibrillation?
Patients with persistent atrial fibrillation
Linear ablation or ablation of complex fractionated electrograms in addition to pulmonary-vein isolation
Pulmonary-vein isolation alone
Rate of recurrent atrial fibrillationhard clinical
Adding linear ablation or ablation of complex fractionated electrograms to pulmonary-vein isolation does not reduce recurrent atrial fibrillation in patients with persistent AF.
Among patients with persistent atrial fibrillation, we found no reduction in the rate of recurrent atrial fibrillation when either linear ablation or ablation of complex fractionated electrograms was performed in addition to pulmonary-vein isolation. (Funded by St. Jude Medical; ClinicalTrials.gov number, NCT01203748.).
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Atul Verma
Chenyang Jiang
Timothy R. Betts
New England Journal of Medicine
McMaster University
Charité - Universitätsmedizin Berlin
The University of Adelaide
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Verma et al. (Wed,) conducted a rct in persistent atrial fibrillation (n=589). Pulmonary-vein isolation vs. Pulmonary-vein isolation plus ablation of complex fractionated electrograms and pulmonary-vein isolation plus linear ablation was evaluated on Freedom from any documented recurrence of atrial fibrillation lasting longer than 30 seconds after a single ablation procedure. (p=0.15). Pulmonary-vein isolation alone achieved 59% freedom from recurrent atrial fibrillation compared to 49% for isolation plus complex electrograms and 46% for isolation plus linear ablation after 18 months, with no significant differences among groups (P=0.15).
www.synapsesocial.com/papers/69626d73832f83540eff1532 — DOI: https://doi.org/10.1056/nejmoa1408288