Arrhythmias & electrophysiologyRandomised controlled trial
Low-Voltage Ablation in Persistent Atrial Fibrillation
- Randomised controlled trial
- multicentre
- 5 Swedish ablation centres
Authors' conclusion
Adjunctive low-voltage zone ablation added to pulmonary vein isolation improved rhythm outcomes and health-related quality of life without increasing serious adverse events in patients with persistent AF and significant low-voltage zones.
Study context
- Population
- Adults undergoing first-time ablation and voltage mapping for persistent atrial fibrillation (AF) with low-voltage zones ≥3.0 cm²randomized of 936 mapped
- Participants
- 209 adults
- Comparison
- Low-voltage zone ablation vs Pulmonary vein isolation alone
- Low-voltage zone ablationn = 102
- Pulmonary vein isolation alonen = 107reference
- Primary endpoint
- Freedom from documented atrial arrhythmia without antiarrhythmic drugs after 1 or 2 ablation procedures within 6 months
- Follow-up
- 12 months
Primary result
As reported in the abstract
Arrhythmia-free survival
Unadjusted difference (95% CI)P value
PVI plus LVZ ablation vs PVI alone
30.3%(17.4%–43.2%)
P < 0.001Odds ratio (95% CI)P value
PVI plus LVZ ablation vs PVI alone
3.5(2.0–6.2)
P < 0.001Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Time to first recurrence after a single procedure without antiarrhythmic drugs | 0.4 (0.3–0.6) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Health-related quality of life
- Greater improvements with low-voltage zone ablation
Safety
Serious adverse events
- Rates similar between groups
Original publication
Low-Voltage Ablation in Persistent Atrial Fibrillation. JAMA. Published 30 August 2026. doi:10.1001/jama.2026.17274
Summarised from the published abstract; every number is checked against it