Arrhythmias & electrophysiologyRandomised controlled trial
Pulmonary Vein Isolation With Optimized Linear Ablation vs Pulmonary Vein Isolation Alone for Persistent Atrial Fibrillation (AF)
- Randomised controlled trial
- investigator-initiated
- multicentre
- open-label
- 12 tertiary hospitals in China
Authors' conclusion
Among patients with persistent AF, linear ablation combined with EIVOM in addition to PVI significantly improved freedom from atrial arrhythmias within 12 months compared with PVI alone.
Study context
- Population
- Patients aged 18 to 80 years with AF persisting >3 months, undergoing first-time AF ablation495 (99.4%) in primary analysis
- Participants
- 498 patients
- Comparison
- Pulmonary vein isolation (PVI) plus Ethanol infusion of the vein of Marshall (EIVOM) and linear ablation vs PVI alone
- PVI plus EIVOM and linear ablationn = 246
- PVI alonen = 249reference
- Primary endpoint
- Freedom from any documented atrial arrhythmias lasting >30 seconds, without antiarrhythmic drugs
- Follow-up
- 12 months
Primary result
As reported in the abstract
Freedom from atrial arrhythmias without antiarrhythmic drugs
Hazard ratio
0.73
95% CI 0.54–0.99
P = 0.045
Events by treatment group
PVI plus EIVOM and linear ablation vs PVI alone
HR 0.73 (95% CI 0.54–0.99); P = 0.045
Secondary outcomes
Prespecified subgroups
- Intervention effect consistent across all prespecified subgroups
Secondary outcomes (freedom from atrial arrhythmia recurrence, AF, recurrence after multiple procedures, atrial tachycardia or flutter; AF burden; quality of life)
- No significant results
Original publication
Pulmonary Vein Isolation With Optimized Linear Ablation vs Pulmonary Vein Isolation Alone for Persistent AF. JAMA. Published 4 February 2025. doi:10.1001/jama.2024.24438
Summarised from the published abstract; every number is checked against it