Arrhythmias & electrophysiologyRandomised controlled trial
Pulmonary vein isolation with or without empiric superior vena cava isolation in patients undergoing ablation for paroxysmal atrial fibrillation: the randomized ESVCI-AF trial
- Randomised controlled trial
- 1:1 randomisation
Authors' conclusion
Among patients with PAF undergoing initial ablation, the addition of empiric SVCI to PVI, compared with PVI alone, did not significantly improve freedom from ATA recurrence.
Study context
- Population
- Patients with paroxysmal atrial fibrillation (AF), aged 18–75 years, undergoing index ablation302 (100%) in efficacy analysis
- Participants
- 302 patients
- Comparison
- Pulmonary vein isolation (PVI) plus empiric SVC isolation (SVCI) vs PVI alone
- PVI plus SVCIn = 151
- PVI alonen = 151reference
- Primary endpoint
- Freedom from atrial arrhythmia recurrence
- Follow-up
- Median 20 months
Primary result
ATA recurrence without antiarrhythmic drugs
Hazard ratio
0.68
95% CI 0.38–1.20
P = 0.182
Events by treatment group
PVI plus SVCI vs PVI alone
HR 0.68 (95% CI 0.38–1.20); P = 0.182
As reported in the abstract
Further findings
Atrial arrhythmia (ATA) recurrence across subgroups
- No significant interaction across subgroups
Original publication
Pulmonary vein isolation with or without empiric superior vena cava isolation in patients undergoing ablation for paroxysmal atrial fibrillation: the randomized ESVCI-AF trial. Europace. Published 14 August 2025. doi:10.1093/europace/euaf175
Summarised from the published abstract; every number is checked against it