EP News| Volume 20, ISSUE 4, P652, April 2023

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EP News: Clinical

Published:February 07, 2023DOI:
      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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