Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Multi-centre, prospective randomized comparison of three different substrate ablation strategies for persistent atrial fibrillation.
Trial report in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies.Reviews in cardiovascular medicine · 2025Pooled it
- Repeat in situ ablation vs. extensive ablation for recurrent persistent atrial fibrillation.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 · 2025Trial
- Individualized dynamic ablation strategy for persistent atrial fibrillation based on ibutilide response.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Article
- High-density mapping guided the modified box and driver ablation for non-paroxysmal atrial fibrillation: a retrospective single-center study.BMC cardiovascular disorders · 2026Article
- Acute Efficacy of Pulsed-Field Ablation of the Mitral Isthmus Using a Pentaspline Catheter and Two Different Ablation Settings.Journal of cardiovascular electrophysiology · 2026Article
- Successful elimination of non-pulmonary vein foci by pulsed-field ablation in a patient with persistent atrial fibrillation: A case report.HeartRhythm case reports · 2025Article
- Re-recognized the maintenance mechanism of persistent atrial fibrillation via electrogram analysis in termination regions.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 · 2025Article
- 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
- Catheter Ablation of Atrial Fibrillation: Technique and Future Perspectives.Journal of clinical medicine · 2025Review
- Aggressive ablation vs. regular ablation for persistent atrial fibrillation: a multicentre real-world cohort study.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 · 2025Observational
- Selective complex fractionated atrial electrogram ablation based on the number-of-fractionation for persistent atrial fibrillation refractory to pulmonary vein isolation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 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 in Atrial Fibrillation: Recent Advances.Journal of clinical medicine · 2024Review
- Ablation Strategies for Persistent Atrial Fibrillation: Beyond the Pulmonary Veins.Journal of clinical medicine · 2024Review
- Repeat ablation of atrial fibrillation using electrogram dispersion to identify additional areas of mechanistic significance.Heart rhythm O2 · 2024Article
- A multicenter, cohort study of catheter ablation for persistent atrial fibrillation with/without atrial fibrillation termination (the termination-atrial fibrillation study).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 · 2024Article
- Pulsed field ablation of spatiotemporal electrogram dispersion following pulmonary vein isolation and left atrial linear lesions for persistent atrial fibrillation: a case report.European heart journal. Case reports · 2024Article
- Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation.Frontiers in physiology · 2024Article
- Dipole Density Guided Catheter Ablation versus Conventional Substrate Modification for Repeat Catheter Ablation of Persistent Atrial Fibrillation.Journal of clinical medicine · 2023Article
- Acute and long-term outcomes of pulmonary vein isolation and left atrial substrate modification for non-paroxysmal atrial fibrillation: a non-randomized trial.Cardiovascular diagnosis and therapy · 2023Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
aimsThe optimal strategy for persistent atrial fibrillation (PerAF) is poorly defined. We conducted a multicentre, randomized, prospective trial to compare the outcomes of different ablation strategies for PerAF. METHODS AND
resultsWe enrolled 450 patients and randomly assigned them in a 1:1:1 ratio to undergo pulmonary vein isolation and subsequently undergo the following three different ablation strategies: anatomical guided ablation (ANAT group, n = 150), electrogram guided ablation (EGM group, n = 150), and extensive electro-anatomical guided ablation (EXT group, n = 150). The primary endpoint was freedom from atrial fibrillation (AF) lasting longer than 30 s at 12 months after a single ablation procedure. After 12 months of follow-up, 72% (108) of patients in the EXT group were free from AF recurrence, as compared with the 64% (96) in the EGM group (P = 0.116), and 54% (81) in the ANAT group (P = 0.002). The EXT group showed less AF/atrial tachycardia recurrence than the EGM group (60% vs. 50%, P = 0.064) and the ANAT group (60% vs. 37.3%, P < 0.001). The EXT group showed the highest rate of AF termination (66.7%), followed by 56.7% in the EGM group, and 20.7% in the ANAT group. The AF termination signified less AF recurrence at 12 months compared to patients without AF termination (30.1% vs. 42.7%, P = 0.008). Safety endpoints did not differ significantly between the three groups (P = 0.924).
conclusionsElectro-anatomical guided ablation achieved the most favourable outcomes among the three ablation strategies. The AF termination is a reliable ablation endpoint.
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