Arrhythmias & electrophysiologyRandomised controlled trial
Personalized pulmonary vein isolation guided by left atrial wall thickness for persistent atrial fibrillation ablation: the persistent atrial fibrillation (PeAF)-by-LAWT randomized trial
- Randomised controlled trial
- non-inferiority
Authors' conclusion
The PeAF-by-LAWT trial is the first prospective randomized study to demonstrate that a personalized LAWT-guided PVI for PeAF ablation is non-inferior to the standard CLOSE protocol in terms of arrhythmia-free survival while significantly improving procedural efficiency.
Study context
- Population
- Consecutive patients referred for first-time persistent AF ablation
- Participants
- 156 patients
- Comparison
- Left atrial wall thickness (LAWT)-guided pulmonary vein isolation (PVI) vs CLOSE protocol-based PVI
- Primary endpoint
- Freedom from atrial arrhythmia recurrence
- Follow-up
- 12 months
Primary result
As reported in the abstract
Atrial arrhythmia-free survival
No significant difference between groups
P = 0.50
Secondary outcomes
Procedure time
P < 0.01
Radiofrequency time
P < 0.01
First-pass PVI
- No difference between groups
- P = 0.72
Safety
Major complication rate
- No difference between groups
- P = 0.99
- not powered to detect differences in safety outcomes
Original publication
Personalized pulmonary vein isolation guided by left atrial wall thickness for persistent atrial fibrillation ablation: the PeAF-by-LAWT randomized trial. Europace. Published 6 August 2025. doi:10.1093/europace/euaf163
Summarised from the published abstract; every number is checked against it