Arrhythmias & electrophysiology
Pulmonary vein isolation and low-voltage area ablation in sinus rhythm for persistent atrial fibrillation: The SCAR-AF randomized trial
Authors' conclusion
In this randomized trial, PVI plus LVA ablation did not improve outcomes in patients with persistent AF. LVA may represent a marker of atrial cardiomyopathy, but its presence does not seem to be an effective target in persistent AF.
Study context
- Population
- Patients with de novo persistent atrial fibrillation (AF), 9 referral centres in France, September 2019 to August 2021
- Participants
- 211 patients
- Comparison
- Pulmonary vein isolation (PVI) plus LVA ablation vs PVI alone
- Primary endpoint
- Freedom from atrial arrhythmias (AF/atrial tachycardia) after a single procedure
- Follow-up
- 18 months
Methodological detailsmulticentre, prospective
- Multicentre
- Prospective
Primary result
As reported in the abstract
Atrial-arrhythmia-free survival
Hazard ratio (95% CI)P value
PVI- vs PVI+
1.28(0.64–2.55)
P = 0.48PVI+ vs PVI + LVA
1.28(0.67–2.45)
P = 0.45Further findings
Factors associated with presence of LVA (multivariable analysis)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Advancing ageAssociated with LVA presence | 1.11 (1.06–1.16) | P < 0.001 | |
| Body mass indexInversely correlated with LVA presence | 0.93 (0.87–0.99) | P = 0.029 | |
| 0.512Hazard ratio (log scale) |
- Smoking inversely correlated with LVA presence
Original publication
Pulmonary vein isolation and low-voltage area ablation in sinus rhythm for persistent atrial fibrillation: The SCAR-AF randomized trial. Heart Rhythm. Published 3 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it