Arrhythmias & electrophysiologySecondary analysis
Radiofrequency catheter ablation of persistent atrial fibrillation by pulmonary vein isolation with or without left atrial posterior wall isolation: long-term outcomes of the CAPLA trial
- Secondary analysis of the CAPLA randomised trial
- multicentre
- international
- long-term follow-up
Authors' conclusion
In patients with persistent AF, the addition of PWI to PVI alone at index radiofrequency CA did not significantly improve freedom from atrial arrhythmia recurrence at long-term follow-up. Median AF burden remains low and AF quality of life high at 3 years with either ablation strategy.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing index radiofrequency catheter ablation333 (98.5%) completed 3-year follow-up
- Participants
- 338 patients
- Comparison
- Pulmonary vein isolation (PVI) + posterior wall isolation (PWI) vs PVI alone
- Primary endpoint
- Freedom from any documented atrial arrhythmia recurrence after a single procedure
- Follow-up
- Median 3.62 years
Primary result
Freedom from recurrent atrial arrhythmia
Hazard ratio
1.15
95% CI 0.88–1.51
P = 0.55
Events by treatment group
PVI + PWI vs PVI alone
HR 1.15 (95% CI 0.88–1.51); P = 0.55
As reported in the abstract
Further findings
| Outcome | Values | P value |
|---|---|---|
| Redo ablation | PVI + PWI 32.0% · PVI alone 29.9% | P = 0.68 |
| AF burden · 3 years | PVI + PWI median 0% (IQR 0%–0.85%) · PVI alone median 0% (IQR 0%–1.43%) | P = 0.49 |
| Sinus rhythm at final clinical follow-up | PVI + PWI 85.1% · PVI alone 87.1% | P = 0.60 |
| AFEQT score · 3 years | PVI + PWI mean 88.0 (SD 14.8) · PVI alone mean 88.9 (SD 15.4) | P = 0.63 |
Time to recurrent atrial arrhythmia
- Median time to recurrence
- 0.53 years (IQR 0.34-1.01 years)
Reconnection at redo
- Pulmonary vein reconnection
- 54.5%
- Mean number of reconnected PVs
- 2.2 ± .9
- Posterior wall reconnection
- 75%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Radiofrequency catheter ablation of persistent atrial fibrillation by pulmonary vein isolation with or without left atrial posterior wall isolation: long-term outcomes of the CAPLA trial. Eur Heart J. Published 31 August 2024. doi:10.1093/eurheartj/ehae580
Summarised from the published abstract; every number is checked against it