Arrhythmias & electrophysiologyRandomised controlled trial
Repeat in situ ablation vs. extensive ablation for recurrent persistent atrial fibrillation
- Randomised controlled trial
Authors' conclusion
Among patients with PerAF undergoing repeat ablation, the EXT group demonstrated superior clinical efficacy compared with the in situ group, indicating that PV reconnection and linear lesion reconduction may not constitute the predominant mechanisms driving AF recurrence.
Study context
- Population
- Patients with recurrent persistent atrial fibrillation (AF) undergoing repeat ablation
- Participants
- 66 vs 66
- Comparison
- Extra-PV extensive ablation vs repeat PV isolation (PVI) and linear ablation
- EXTn = 66
- In situn = 66reference
- Primary endpoint
- Freedom from AF/atrial tachycardia (AT) episodes lasting >30 s
- Follow-up
- 12 months
Primary result
As reported in the abstract
Hazard ratio
0.587
95% CI 0.348–0.992
log-rank P = 0.037
Events by treatment group
EXT vs In situ
HR 0.587 (95% CI 0.348–0.992); log-rank P = 0.037
Further findings
| Outcome | EXT | In situ | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Freedom from AF recurrence | 77.3% | 60.6% | 0.509 (0.278–0.932) | log-rank P = 0.027 | |
| 0.20.5125Hazard ratio (log scale) |
Safety
Safety endpoints · no significant difference
P = 0.716
Original publication
Repeat in situ ablation vs. extensive ablation for recurrent persistent atrial fibrillation. Europace. Published 22 September 2025. doi:10.1093/europace/euaf232
Summarised from the published abstract; every number is checked against it