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 Cardiology2025
Circumferential pulmonary vein isolation with adjunctive linear ablation vs. circumferential pulmonary vein isolation alone for long-standing persistent atrial fibrillation: a randomized pilot study.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ethanol infusion of the vein of marshall-based strategies for persistent atrial fibrillation: a systematic review and meta-analysis of randomized trials.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 · 2026Pooled it
- Ethanol Infusion in the Vein of Marshall as an Adjunct to Catheter Ablation in Persistent Atrial Fibrillation.Pacing and clinical electrophysiology : PACE · 2026Article
- Letter on 'Circumferential pulmonary vein isolation (CPVI) with adjunctive linear ablation vs. CPVI alone for long-standing persistent atrial fibrillation: a randomized pilot 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 · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
aimsThis prospective randomized controlled trial investigated the comparative efficacy and safety of circumferential pulmonary vein isolation (CPVI) combined with modified linear ablation (CPVI-MLA) vs. standalone CPVI in patients with long-standing persistent atrial fibrillation (LSPAF). METHODS AND
resultsIn this single-centre pilot trial, 134 LSPAF patients were randomized to the CPVI-MLA (n = 67) or CPVI-only (n = 67) groups. The CPVI-MLA protocol integrated four components: (i) ethanol infusion targeting the ligament of Marshall; (ii) complete CPVI; (iii) extended lesion sets (posterior wall isolation, dual isthmus ablation); and (iv) substrate modification [left atrial intima adjoining coronary sinus (LAI-CS) and superior vena cava isolation (SVCI)]. A 24 h Holter monitoring was performed at the 1st, 3rd, and 6th month follow-up visits, with 7-day Holter monitoring at the 12th month follow-up visit. The primary endpoint was freedom from atrial tachyarrhythmias (≥ 30 s) after the initial 3-month blanking period post-index procedure, without antiarrhythmic drugs. After a mean follow-up of 14.5 ± 9.1 months, 76.1% (51/67) in the CPVI-MLA group and 65.7% (44/67) in the CPVI-only group achieved the primary endpoint (P = 0.32). However, the CPVI-MLA group demonstrated significantly higher atrial fibrillation (AF)-free survival rate (91.0 vs. 76.1%, P = 0.049), while atrial tachycardia/atrial flutter-free survival rates were comparable (83.5 vs. 88.1%, P = 0.45). The CPVI-MLA strategy required longer ablation time (68.6 ± 12.3 vs. 49.4 ± 10.3 min, P < 0.001) and fluoroscopy exposure (14.9 ± 9.8 vs. 9.3 ± 6.7 min, P < 0.001). Serious adverse events were rare and similar between groups (1.5 vs. 0%, P = 1.00).
conclusionIn patients with LSPAF, the CPVI-MLA strategy significantly improved freedom from AF compared with CPVI alone, although it did not improve overall sinus rhythm maintenance rate. This strategy may offer a refined approach for complex AF ablation, warranting further validation in larger trials.
Indexed as
Identifiers
What OpenQuestion holds
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.