Trial reportJournal of the American Heart Association2025
Prospective Randomized Trial of Rotor Ablation vs Conventional Ablation for Persistent Atrial Fibrillation: REAFFIRM Trial.
Trial report in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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
14 citing papers in PubMed.
- Editorial commentary: Pulsed field versus thermal ablation for atrial fibrillation.Trends in cardiovascular medicine · 2026Article
- Convergent Hybrid Ablation Versus Catheter Ablation in Patients With Persistent Atrial Fibrillation and Heart Failure: HALT AF Study Protocol and Rationale for a Multicenter Randomized Controlled Trial.Journal of the American Heart Association · 2026Article
- Towards mechanisms-driven strategy for persistent atrial fibrillation ablation: Leveraging digital twins.Journal of precision medicine (Amsterdam, Netherlands) · 2026Article
- Relationships between three-dimensional fibrosis distribution, atrial adiposity, and voltage abnormalities associated with 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 · 2026Article
- Mechanistic Insights From Trials of Atrial Fibrillation Ablation: Charting a Course for the Future.Circulation. Arrhythmia and electrophysiology · 2024Review
- Catheter Ablation of Persistent AF-Where are We Now?Reviews in cardiovascular medicine · 2023Review
- Electrogram Morphology Recurrence for Mapping Persistent Atrial Fibrillation: Initial vs Redo Catheter Ablation.JACC. Clinical electrophysiology · 2023Article
- Machine Learning-Enabled Multimodal Fusion of Intra-Atrial and Body Surface Signals in Prediction of Atrial Fibrillation Ablation Outcomes.Circulation. Arrhythmia and electrophysiology · 2022Article
- Impact of Adenosine on Wavefront Propagation in Persistent Atrial Fibrillation: Insights From Global Noncontact Charge Density Mapping of the Left Atrium.Journal of the American Heart Association · 2022Article
- A novel approach for quantitative electrogram analysis for driver identification: Implications for ablation in persistent atrial fibrillation.Frontiers in cardiovascular medicine · 2022Article
- Ablation guided by STAR-mapping in addition to pulmonary vein isolation is superior to pulmonary vein isolation alone or in combination with CFAE/linear ablation for persistent AF.Journal of cardiovascular electrophysiology · 2021Article
- The interconnected atrium: Acute impact of pulmonary vein isolation on remote atrial tissue.Journal of cardiovascular electrophysiology · 2020Article
- Noninvasive Assessment of Complexity of Atrial Fibrillation: Correlation With Contact Mapping and Impact of Ablation.Circulation. Arrhythmia and electrophysiology · 2020Article
- Mapping and Ablation of Rotational and Focal Drivers in Atrial Fibrillation.Cardiac electrophysiology clinics · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary vein isolation (PVI) is the cornerstone therapy for symptomatic drug-refractory atrial fibrillation yet is not curative in a large segment of patients. Focal and rotational drivers are proposed to be involved in atrial fibrillation mechanisms but their ablation has produced variable outcomes. REAFFIRM (The Randomized Evaluation of Atrial Fibrillation Treatment with Focal Impulse and Rotor Modulation Guided Procedures) trial (NCT-02274857) objective was to compare the safety and effectiveness of conventional ablation with and without Focal Impulse and Rotor Modulated (FIRM) ablation, guided by global basket mapping, for the treatment of persistent atrial fibrillation.
methodsThree hundred seventy-five patients were enrolled and randomized at 18 centers. The Intent-to-Treat population consisted of 350 patients (171 FIRM, 179 Conventional). Primary effectiveness was defined as single procedure freedom from atrial fibrillation/atrial tachycardia recurrence at 3 to 12 months post index procedure.
resultsThree hundred twenty-four patients completed the 12-month follow-up. Patients in the FIRM arm had a larger left atrium (
conclusionsIntention-to-treat analysis failed to provide evidence for the superiority of adding ablation of focal or rotational sites to conventional ablation. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT-02274857.
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