Arrhythmias & electrophysiologyRandomised controlled trial
Impact of linear ablation in persistent atrial fibrillation using a dual-energy, wide-footprint catheter: Analysis from the SPHERE Per-AF randomized trial
- Analysis from the SPHERE Per-AF randomized trial
Authors' conclusion
There was a trend toward numerically higher effectiveness with linear lesions than PVI alone. These findings are exploratory and hypothesis generating and should prompt future randomized controlled trials of additional lesion sets vs PVI with this new technology.
Study context
- Population
- Patients with persistent atrial fibrillation
- Comparison
- investigational arm vs control arm
Primary result
As reported in the abstract
Linear lesions received
| Group | left atrial roof and/or posterior wall isolation | cavotricuspid isthmus line | mitral line |
|---|---|---|---|
| investigational arm | 203 patients (95.8%) | 117 (55.2%) | 76 (35.8%) |
| control arm | 102 patients (68.9%) | 76 (51.4%) | 19 (12.8%) |
Further findings
Transpired ablation and energy application times
- Shorter for each lesion type using the investigational than the control catheter
- all P < .0001
12-month effectiveness, pulmonary vein isolation (PVI) + all linear lesions combined (n = 25) vs PVI-only (n = 56)
- Trend toward numerically higher effectiveness of PVI + all linear lesions combined than PVI-only
- P = 0.07
- Effect more pronounced in the investigational arm
- subgroups were small
Original publication
Impact of linear ablation in persistent atrial fibrillation using a dual-energy, wide-footprint catheter: Analysis from the SPHERE Per-AF randomized trial. Heart Rhythm. Published 6 February 2026. doi:10.1016/j.hrthm.2026.01.037
Summarised from the published abstract; every number is checked against it