Arrhythmias & electrophysiology
Persistent Atrial Fibrillation Phenotypes and Ablation Outcomes: Persistent From Outset vs Progression From Paroxysmal Atrial Fibrillation (AF)
Authors' conclusion
In the CAPLA cohort of patients, pattern of AF at first diagnosis did not influence post-ablation rate of AF recurrence or AF burden.
Study context
- Population
- Patients with persistent AF randomised to PVI plus PWI or PVI alone in the CAPLA trial
- Participants
- 334 patients
- Comparison
- PsAF at first diagnosis vs progression from paroxysmal atrial fibrillation (PAF)
- PsAF at diagnosisn = 194
- PAFn = 140reference
- Primary endpoint
- AF recurrence post ablation (after 3-month blanking period)
- Follow-up
- 12 months
Methodological detailsmulticentre, Outcomes assessed after a 3-month blanking period
- Multicentre
- Outcomes assessed after a 3-month blanking period
Primary result
As reported in the abstract
AF recurrence
PsAF at diagnosis vs PAFHazard ratio (95% CI)P value
Univariable
0.802(0.585–1.101)
P = 0.173Multivariable
0.922(0.647–1.312)
P = 0.650Further findings
Age
P = 0.005
| Outcome | PsAF at diagnosis | PAF | P value |
|---|---|---|---|
| AF burdenMedian | 0% | 0% | P = 0.125 |
| LVEF | 54.5% (IQR 40%–60%) | 60% (IQR 50%–61%) | P = 0.007 |
HF, left atrial size, bipolar voltage
- Higher rates of HF with PsAF at diagnosis
- P < 0.001
- No difference in left atrial size
- P = 0.337
- No difference in bipolar voltage
- P = 0.579
Original publication
Persistent Atrial Fibrillation Phenotypes and Ablation Outcomes: Persistent From Outset vs Progression From Paroxysmal AF. JACC Clin Electrophysiol. Published 27 September 2024. doi:10.
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