Arrhythmias & electrophysiology
Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence: The AWARE Randomized Clinical Trial
Primary resultResult — go to the resultRelative risk 0.92 95% CI 0.66–1.29Authors' conclusion
In this randomized clinical trial of patients with paroxysmal AF, additional ablation by performing a double ablation lesion set did not result in improved freedom from recurrent AA compared with a standard single ablation set.
Study context
- Population
- Adults ≥18 years with symptomatic paroxysmal atrial fibrillation (AF) undergoing radiofrequency catheter ablation for pulmonary vein isolation
- Participants
- 398 adults
- Comparison
- Augmented double wide-area circumferential ablation (WACA) vs standard single WACA
- Double WACAn = 203
- Single WACAn = 195reference
- Primary endpoint
- Atrial arrhythmias (AA) recurrence
- Follow-up
- Between 91 and 365 days postablation
Methodological detailspragmatic, multicentre, prospective, open, blinded end point, superiority, 10 university-affiliated centres in Canada
- Pragmatic
- Multicentre
- Prospective
- Open
- Blinded end point
- Superiority
- 10 university-affiliated centres in Canada
Primary result
As reported in the abstract
1 year
Relative risk
0.92
95% CI 0.66–1.29
P = 0.64
Events by treatment group
Double WACA vs Single WACA
RR 0.92 (95% CI 0.66–1.29); P = 0.64
Secondary outcomes
| Outcome | Single WACA | Double WACA | RR (95% CI) | |
|---|---|---|---|---|
| Repeated catheter ablation | 10.3% | 7.4% | 0.72 (0.38–1.36) | |
| 0.20.5125Relative risk (log scale) |
Safety
Adjudicated serious adverse events
Original publication
Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence: The AWARE Randomized Clinical Trial. JAMA Cardiol. Published 1 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it