Background

Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) is associated with a non-negligible long-term recurrence rate.

Objectives

The purpose of this study was to investigate whether PVI combined with 6 short ablation lines on the PVI circumferences (PVI+6L group) yields higher success rates than PVI alone (PVI group).

Methods

In this multicenter, single-blind, randomized trial, a total of 390 patients with paroxysmal AF were randomly assigned to the PVI group (n = 193) or the PVI+6L group (n = 197). The primary endpoint was freedom from AF/atrial tachycardia recurrence between 91 and 365 days. Secondary endpoints included AF burden, procedural parameters, and complications.

Results

Freedom from atrial tachyarrhythmia was achieved in 160 of 197 patients (81.2%) in the PVI+6L group and 142 of 193 patients (73.6%) in the PVI group (hazard ratio 0.61; 95% confidence interval 0.39–0.97; P = .040). Mean AF burden tended to be lower in the PVI+6L group compared to the PVI group (1.95% vs 0.53%, P = .097). Procedural and ablation times were slightly longer in the PVI+6L group than in the PVI group (130 ± 25 minutes vs 121 ± 28 minutes; P = .002; and 46 ± 14 minutes vs 41 ± 16 minutes, P = .001, respectively). X-ray exposure was similar (60 ± 54 seconds vs 61 ± 60 seconds; P = .964). Complications occurred in 3 patients (1.6%) in the PVI group and 3 patients (1.5%) in the PVI+6L group.

Conclusion

In patients with paroxysmal AF undergoing catheter ablation, adding 6 short ablation lines on the PVI circumferences could reduce the AF recurrence rate.

中文翻译：

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在肺静脉隔离圆周上添加 6 条短线可减少阵发性心房颤动的复发：来自多中心、单盲、随机试验的结果

背景

阵发性心房颤动 (AF) 的肺静脉隔离 (PVI) 与不可忽略的长期复发率相关。

目标

本研究的目的是调查 PVI 与 PVI 圆周上的 6 条短消融线（PVI+6L 组）是否比单独的 PVI（PVI 组）产生更高的成功率。

方法

在这项多中心、单盲、随机试验中，共有 390 名阵发性 AF 患者被随机分配到 PVI 组 (n = 193) 或 PVI+6L 组 (n = 197)。主要终点是 91 至 365 天之间无 AF/房性心动过速复发。次要终点包括 AF 负担、程序参数和并发症。

结果

PVI+6L 组 197 名患者中的 160 名（81.2%）和 PVI 组 193 名患者中的 142 名（73.6%）实现了房性快速性心律失常（风险比 0.61；95% 置信区间 0.39-0.97；P = . 040)。与 PVI 组相比，PVI+6L 组的平均 AF 负担往往较低（1.95% 对 0.53%，P = .097）。PVI+6L 组的手术和消融时间略长于 PVI 组（130 ± 25 分钟 vs 121 ± 28 分钟；P = .002；46 ± 14 分钟 vs 41 ± 16 分钟，P = .001，分别）。X 射线曝光相似（60 ± 54 秒对 61 ± 60 秒；P = .964）。PVI组3例患者（1.6%）和PVI+6L组3例患者（1.5%）出现并发症。

结论

在阵发性房颤患者导管消融中，在 PVI 圆周上增加 6 条短消融线可降低房颤复发率。