Arrhythmias & electrophysiology
Aggressive ablation vs. regular ablation for persistent atrial fibrillation: a multicentre real-world cohort study
Corrected 23 Oct 2026: Measure wording clarified; no values changed.
Authors' conclusion
Aggressive ablation achieved more favourable outcomes than regular ablation, and moderately aggressive ablation may be associated with better clinical outcomes.
Study context
- Population
- Patients with persistent AF undergoing catheter ablationPropensity score (PS)-matched 1560 each
- Participants
- 4,833 patients
- Exposure
- Aggressive ablation vs regular ablation
- Aggressiven = 1,560
- Regularn = 1,560reference
- Outcome
- AF/AT recurrence-free survival off anti-arrhythmic drugs after a single procedure
- Follow-up
- 12 months
Methodological detailsmulticentre, propensity-score matched, 10 centres
- Multicentre
- Propensity-score matched
- 10 centres
Main finding
AF/AT-free survival
Hazard ratio
0.745
event not clearly stated
P < 0.001
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
AT recurrence · 12 months
P = 0.539
Procedural AF termination
P < 0.001
| Outcome | Aggressive | Regular | P value |
|---|---|---|---|
| AF/AT-free survival, with vs without AF termination | P < 0.001 | ||
| AF/AT-free survival, anatomical vs PVI-only (within regular, PS-matched n = 455 each) | P = 0.122 | ||
| AF/AT-free survival, aggressive vs anatomical alone (PS-matched n = 1362 each) | 67.5% | — not stated in the abstract | P < 0.001 |
— not stated in the abstract
- AF/AF/atrial tachycardia (AT)-free survival, with vs without AF termination: AF termination 72.3%
- AF/AT-free survival, with vs without AF termination: No AF termination 55.2%
- AF/AT-free survival, anatomical vs PVI-only (within regular, PS-matched n = 455 each): Anatomical 60.7%
- AF/AT-free survival, anatomical vs PVI-only (within regular, PS-matched n = 455 each): PVI-only 55.6%
- AF/AT-free survival, aggressive vs anatomical alone (PS-matched n = 1362 each): Anatomical 59.9%
Safety
Safety endpoints
- Did not differ significantly between the two groups
Original publication
Aggressive ablation vs. regular ablation for persistent atrial fibrillation: a multicentre real-world cohort study. Europace. Published 6 March 2025. doi:10.
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