Kistler et al (JAMA 2023;329:127, PMID 36625809) compared pulmonary vein isolation
(PVI) with posterior wall isolation (PWI) vs PVI alone in symptomatic patients with
persistent AF undergoing first-time catheter ablation in a prospective randomized
trial. The PVI with PWI group (n = 170) underwent wide antral PVI and PWI. The PVI
alone group (n = 168) underwent wide antral PVI alone. The primary end point was freedom
from any atrial arrhythmia more than 30 seconds without antiarrhythmic medication
at 12 months. After 12 months, 89 patients (52.4%) assigned to PVI with PWI were free
from the primary end point as compared with 90 (53.6%) assigned to PVI alone (hazard
ratio 0.99; P = .98). The authors conclude that in patients undergoing first-time catheter ablation for
persistent AF, the addition of PWI to PVI alone did not significantly improve freedom
from atrial arrhythmia compared with PVI alone.
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Publication history
Published online: February 07, 2023
Footnotes
Funding Sources: The author has no funding sources to disclose. Disclosures: The author has no conflicts of interest to disclose.
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