Arrhythmias & electrophysiology
Ostial vs. wide area circumferential ablation guided by the Ablation Index in paroxysmal atrial fibrillation
Main finding · Acute PV reconnection (per PV)Result — go to the resultAdjusted odds ratio 0.51 95% CI 0.23–0.83Authors' conclusion
In paroxysmal AF patients treated with tailored AI-guided PVI, ostial circumferential ablation is not inferior to WACA with regard to acute PV reconnection, while allowing quicker procedures with less ablation time.
Study context
- Population
- Consecutive patients referred for paroxysmal atrial fibrillation (AF) ablation, January 2020 to September 2021
- Participants
- 162 patients · 304 vs 301 pulmonary vein (PVs)
- Exposure
- Ostial circumferential ablation vs wide-area circumferential ablation (WACA), Ablation Index (AI)-guided pulmonary vein isolation (PVI)
- Ostialn = 81
- WACAn = 81reference
- Outcome
- Acute PV reconnection
Methodological detailsmulticentre, non-randomized, non-inferiority, consecutive patients
- Multicentre
- Non-randomized
- Non-inferiority
- Consecutive patients
Main finding
Acute PV reconnection (per PV)
Adjusted odds ratio
0.51
95% CI 0.23–0.83
P = 0.05
By group
Ostial vs WACA
adjusted OR 0.51 (95% CI 0.23–0.83); P = 0.05
As reported in the abstract
Observational data: associations, not effects.
Further findings
Ablation time
P = 0.001
Procedure time
P < 0.001
| Outcome | WACA | Ostial | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Arrhythmia recurrence · 1 year | 11.1% | 9.9% | 1.13 (0.44–1.94) | P = 0.80 for superiority | |
| 0.512Hazard ratio (log scale) |
Original publication
Ostial vs. wide area circumferential ablation guided by the Ablation Index in paroxysmal atrial fibrillation. Europace. Published 22 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it