Arrhythmias & electrophysiology
Lesion delivery and scar formation in catheter ablation for atrial fibrillation: The DECAAF II trial
Primary resultResult — go to the resultHazard ratio 0.90 95% CI 0.80–1.01Authors' conclusion
Radiofrequency ablation lesions do not uniformly result in scar formation. A post hoc analysis suggests reduced arrhythmia recurrence when ablation-induced scarring covers fibrotic regions in patients with low baseline fibrosis.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) treated with radiofrequency ablationanalysed
- Participants
- 593 patients
- Comparison
- Pulmonary vein isolation (PVI) plus delayed enhancement magnetic resonance imaging (DE-MRI) fibrosis-guided ablation vs PVI alone
- Fibrosis-guidedn = 300
- PVIn = 293reference
Methodological detailspost hoc analysis
- Post hoc analysis
Primary result
As reported in the abstract
Hazard ratio
0.90
95% CI 0.80–1.01
P = 0.08
Fibrosis coverage with scar
HR 0.90 (95% CI 0.80–1.01); P = 0.08
Per 20% increase, as printed
Further findings
≥40% of baseline fibrosis targeted by lesions
P < 0.001
≥40% of fibrosis covered by scar on 3-month DE-MRI
P < 0.001
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Recurrence by baseline fibrosis (subgroup)Fibrosis coverage with scarvs PVIBaseline fibrosis < 20% | 0.85 (0.73–0.97) | P = 0.03 | |
| 0.512Hazard ratio (log scale) |
Recurrence by baseline fibrosis (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Fibrosis coverage with scarBaseline fibrosis ≥ 20% | 0.97 (0.80–1.17) | P = 0.77 | |
| 0.512Hazard ratio (log scale) |
Center variation
- Significant center variation in fibrosis targeting and coverage with scarring
Original publication
Lesion delivery and scar formation in catheter ablation for atrial fibrillation: The DECAAF II trial. Heart Rhythm. Published 6 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →