Randomised controlled trial

Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence

JAMA CardiolPublished

  • Randomised controlled trial
  • pragmatic
  • multicentre
  • prospective
  • open
  • blinded end point
  • superiority
  • 10 university-affiliated centres in Canada

Authors' conclusion

In this randomized clinical trial of patients with paroxysmal AF, additional ablation by performing a double ablation lesion set did not result in improved freedom from recurrent AA compared with a standard single ablation set.

Study context

Population
Adults ≥18 years with symptomatic paroxysmal atrial fibrillation (AF) undergoing radiofrequency catheter ablation for pulmonary vein isolation
Participants
398 adults
Comparison
Augmented double wide-area circumferential ablation (WACA) vs standard single WACA
  • Double WACAn = 203
  • Single WACAn = 195reference
Primary endpoint
Atrial arrhythmias (AA) recurrence
Follow-up
Between 91 and 365 days postablation

Primary result

As reported in the abstract

1 year

Relative risk

0.92

95% CI 0.66–1.29

P = 0.64

Events by treatment group

Double WACA vs Single WACA
RR 0.92 (95% CI 0.66–1.29); P = 0.64

Secondary outcomes

OutcomeSingle WACADouble WACARR (95% CI)
Repeated catheter ablation10.3%7.4%0.72 (0.38–1.36)

Safety

Adjudicated serious adverse events

Original publication

Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence. JAMA Cardiol. Published 1 May 2023. doi:10.1001/jamacardio.2023.0212

Summarised from the published abstract; every number is checked against it