Arrhythmias & electrophysiology
A Randomized Trial of Electrographic Flow-Guided Redo Ablation for Nonparoxysmal Atrial Fibrillation (FLOW-AF)
Authors' conclusion
In nonparoxysmal AF patients undergoing redo ablation, EGF mapping identified AF sources in 60% of patients, and could be successfully ablated in 95%. Compared with PVI alone, PVI + source ablation improved AF-free survival by 51% on an absolute basis.
Study context
- Population
- Persistent/long-standing persistent atrial fibrillation (AF) patients undergoing redo ablation; randomised if electrographic flow (EGF) source activity ≥26.5%enrolled
- Participants
- 85 patients
- Comparison
- PVI + EGF-guided ablation vs PVI only
- EGF-guided ablationn = 22
- Controln = 26reference
- Primary endpoint
- AF-free survival
- Follow-up
- 12 months
Methodological detailsmulticentre, 4 centres
- Multicentre
- 4 centres
Primary result
As reported in the abstract
P = 0.042
Further findings
Freedom from AF/atrial tachycardia/atrial flutter · 12 months
P = 0.103
EGF sources above threshold
- No sources above threshold
- 34 (40%)
- ≥1 source above threshold
- 46 (60%)
- EGF-identified sources successfully ablated
- 95%
Safety
- Freedom from safety events
- 97.2%
Original publication
A Randomized Trial of Electrographic Flow-Guided Redo Ablation for Nonparoxysmal Atrial Fibrillation (FLOW-AF). JACC Clin Electrophysiol. Published 5 June 2024. doi:10.
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