Arrhythmias & electrophysiologyRandomised controlled trial
Circumferential Pulmonary Vein Isolation With vs Without Additional Low-Voltage-Area Ablation in Older Patients With Paroxysmal Atrial Fibrillation
- Randomised controlled trial
- investigator-initiated
- multicentre (14 tertiary hospitals in China)
- 1:1 randomisation
Authors' conclusion
This study found that additional low-voltage-area ablation beyond CPVI decreased the ATA recurrence in older patients with paroxysmal AF compared with CPVI alone.
Study context
- Population
- Patients aged 65 to 80 years with paroxysmal atrial fibrillation (AF) referred for catheter ablation, China, 2018–202024 excluded from efficacy analysis
- Participants
- 438 patients
- Comparison
- Circumferential pulmonary vein isolation (CPVI) plus low-voltage-area ablation vs CPVI alone
- CPVI plusn = 209
- CPVI alonen = 205reference
- Primary endpoint
- Freedom from atrial tachyarrhythmia (ECG-documented at a clinical visit or >30 s on Holter) after a single ablation procedure
- Follow-up
- Median 23 months
Primary result
Recurrence of atrial tachyarrhythmia
Hazard ratio
0.61
95% CI 0.38–0.95
P = 0.03
Events by treatment group
CPVI plus vs CPVI alone
HR 0.61 (95% CI 0.38–0.95); P = 0.03
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| ATA recurrence, patients with low-voltage area (subgroup) · 51% decreased risk | 0.49 (0.25–0.94) | P = 0.03 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Circumferential Pulmonary Vein Isolation With vs Without Additional Low-Voltage-Area Ablation in Older Patients With Paroxysmal Atrial Fibrillation. JAMA Cardiol. Published 1 August 2023. doi:10.1001/jamacardio.2023.1749
Summarised from the published abstract; every number is checked against it