Arrhythmias & electrophysiologyRandomised controlled trial
Circumferential pulmonary vein isolation with adjunctive linear ablation vs. circumferential pulmonary vein isolation alone for long-standing persistent atrial fibrillation: a randomized pilot study
- Randomised controlled trial
- single-centre
- pilot
Authors' conclusion
In patients with LSPAF, the CPVI-MLA strategy significantly improved freedom from AF compared with CPVI alone, although it did not improve overall sinus rhythm maintenance rate.
Study context
- Population
- Patients with long-standing persistent atrial fibrillation (AF) (long-standing persistent atrial fibrillation (LSPAF))
- Participants
- 134 patients
- Comparison
- Circumferential pulmonary vein isolation (CPVI) with modified linear ablation vs CPVI alone
- CPVI-MLAn = 67
- CPVI-onlyn = 67reference
- Primary endpoint
- Freedom from atrial tachyarrhythmias (≥ 30 s) after the 3-month blanking period, without antiarrhythmic drugs
- Follow-up
- Mean 14.5 ± 9.1 months
Primary result
As reported in the abstract
P = 0.32
Further findings
AF-free survival
P = 0.049
Atrial tachycardia/atrial flutter-free survival
P = 0.45
Ablation time
P < 0.001
Fluoroscopy exposure
P < 0.001
Safety
Serious adverse events
- Serious adverse events rare and similar between groups (CPVI-MLA vs CPVI-only)
- 1.5 vs. 0%, P = 1.00
Original publication
Circumferential pulmonary vein isolation with adjunctive linear ablation vs. circumferential pulmonary vein isolation alone for long-standing persistent atrial fibrillation: a randomized pilot study. Europace. Published 13 August 2025. doi:10.1093/europace/euaf176
Summarised from the published abstract; every number is checked against it