Trial reportJournal of the American Heart Association2017
Does Additional Electrogram-Guided Ablation After Linear Ablation Reduce Recurrence After Catheter Ablation for Longstanding Persistent Atrial Fibrillation? A Prospective Randomized Study.
Trial report in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Representation of Women in Atrial Fibrillation Ablation Randomized Controlled Trials: Systematic Review.Journal of the American Heart Association · 2025Pooled it
- Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMC medicine · 2022Pooled it
- Is ablation to atrial fibrillation termination of persistent atrial fibrillation the end point?: A systematic review and meta-analysis.Medicine · 2019Pooled it
- Pooled it
- Atrial bipolar voltage analysis to assess vein of Marshall ethanol infusion acute effectiveness and its implication in predicting mitral isthmus block.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Targeting the Substrate: Mechanism-Based Ablation Strategies for Persistent Atrial Fibrillation.Journal of clinical medicine · 2025Review
- Persistent atrial fibrillation ablation: glimpsing the light ahead?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Individually designed ablation of low-voltage areas in persistent atrial fibrillation-a randomized controlled trial (IDEAL-AF): study design and rationale.European heart journal open · 2025Article
- Instant termination as a novel indicator for prognosis of persistent atrial fibrillation during cryoballoon ablation: a propensity score-matched analysis.Frontiers in cardiovascular medicine · 2025Article
- Catheter ablation for non-paroxysmal atrial fibrillation. A review.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2024Review
- A novel stepwise catheter ablation method of the mitral isthmus for persistent atrial fibrillation: efficacy and reproducibility.BMC cardiovascular disorders · 2023Article
- Reablation in Atrial Fibrillation Recurrence and Pulmonary Vein Reconnection: Cryoballoon versus Radiofrequency as Index Ablation Procedures.Journal of clinical medicine · 2022Article
- Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives.Biomedicines · 2022Review
- Clinical Usefulness of Virtual Ablation Guided Catheter Ablation of Atrial Fibrillation Targeting Restitution Parameter-Guided Catheter Ablation: CUVIA-REGAB Prospective Randomized Study.Korean circulation journal · 2022Article
- Comparison of the empirical linear ablation and low voltage area-guided ablation in addition to pulmonary vein isolation in patients with persistent atrial fibrillation: a propensity score-matched analysis.BMC cardiovascular disorders · 2022Article
- Current progress of computational modeling for guiding clinical atrial fibrillation ablation.Journal of Zhejiang University. Science. B · 2021Review
- Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation.Journal of arrhythmia · 2019Article
- Catheter Ablation of Long-standing Persistent Atrial Fibrillation: a Reckless Challenge or a Way to Real Cure?Korean circulation journal · 2019Review
- Ablation of long-standing persistent atrial fibrillation.Annals of translational medicine · 2017Review
- Atrial Electrogram Fractionation Distribution before and after Pulmonary Vein Isolation in Human Persistent Atrial Fibrillation-A Retrospective Multivariate Statistical Analysis.Frontiers in physiology · 2017Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough circumferential pulmonary vein isolation (CPVI) catheter ablation may not be sufficient for long-standing persistent atrial fibrillation (L-PeAF), it is not clear which ablation strategy is beneficial in addition to CPVI. We sought to investigate whether additional complex fractionated atrial electrogram (CFAE)-guided ablation improves clinical outcomes in L-PeAF patients who exhibit continuous atrial fibrillation (AF) after CPVI and linear ablation (Line). METHODS AND
resultsThis study enrolled 137 L-PeAF patients (71.4% male, 61.6±10.9 years old) who underwent radiofrequency catheter ablation. We conducted CPVI+Line based on the Dallas lesion set (posterior box+anterior line) after baseline CFAE mapping in all patients. If AF was defragmented (terminated or changed to atrial tachycardia), the procedure was stopped (AF-Defrag group, n=29). If AF was maintained after CPVI+Line, we mapped the CFAE again and randomly assigned the patient to the CPVI+Line group (n=54) or the additional CFAE ablation group (CPVI+Line+CFAE group, n=54). L-PeAF was defragmented during CPVI+Line in 21.2% of patients (29/137, AF-Defrag group). The mean CFAE cycle length was prolonged (P<0.001), and CFAE area (CFAE cycle length <120 milliseconds) was reduced (P<0.001) after CPVI+Line in the remaining patients. Procedure time was longer in the CPVI+Line+CFAE group than the CPVI+Line group (P=0.023), but procedure-related complication rates did not vary. During 22.3±13.2 months of follow-up, the clinical recurrence rates were 17.2% in the AF-Defrag group, 18.5% in the CPVI+Line group, and 32.1% in the CPVI+Line+CFAE group (log rank, P=0.166).
conclusionsAlthough CPVI+Line reduces and localizes CFAE area, additional CFAE ablation after CPVI+Line does not improve the clinical outcomes of catheter ablation in patients with L-PeAF.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.