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
Pulmonary vein isolation with or without empiric superior vena cava isolation in patients undergoing ablation for paroxysmal atrial fibrillation: the randomized ESVCI-AF trial.
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 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Empirical Superior Vena Cava Isolation Added to Pulmonary Vein Isolation in Atrial Fibrillation: A Systematic Review and Meta-Analysis.BMC cardiovascular disorders · 2026Pooled it
- Targeted Superior Vena Cava Isolation Combined With Pulmonary Vein Isolation Versus Pulmonary Vein Isolation Alone Using Cryoballoon Ablation for Atrial Fibrillation.Clinical cardiology · 2026Article
- Standardised superior vena cava isolation with a balloon-in-basket pulsed-field ablation catheter: feasibility and acute safety of two procedural workflows in 53 consecutive patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Feasibility and Safety of High-Power Settings for Electrical Isolation of the Superior Vena Cava Using a Catheter Capable of Local Impedance and Contact Force Monitoring.Journal of arrhythmia · 2026Article
- Empiric superior vena cava isolation in atrial fibrillation ablation: an updated meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Superior vena cava and atrial cardiomyopathy: role of adjunctive superior vena cava isolation ablation in 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 · 2025Article
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Abstract
aimsThe superior vena cava (SVC) has been implicated as a non-pulmonary vein trigger in the initiation and maintenance of atrial fibrillation (AF). However, the incremental benefit of empiric SVC isolation (SVCI) in addition to pulmonary vein isolation (PVI) for paroxysmal AF (PAF) remains inconclusive. This study aimed to determine whether adding empiric SVCI to PVI improves freedom from atrial arrhythmia (ATA) recurrence in patients with PAF. METHODS AND
resultsA total of 302 patients with PAF, aged 18-75 years, undergoing index ablation, were enrolled and randomized in a 1:1 ratio to either the PVI plus SVCI group or the PVI alone group between May 2021 and February 2024. In the PVI plus SVCI group, PVI was performed first, followed by empiric SVCI. In the PVI alone group, only PVI was performed. Among 302 randomized patients [median (IQR) age, 64.9 (56.0-70.0) years, 165 men (54.6%)], 302 (100%) completed the 3-month blanking period and contributed to the efficacy analysis. After a median follow-up of 20 months, the recurrence of rate of ATAs did not differ significantly between the PVI plus SVCI group (20/151 patients, 13.2%) and PVI alone group (29/151, 19.2%) without taking antiarrhythmic drugs (hazard ratio, 0.68, 95% confidence interval 0.38-1.20, P = 0.182). Subgroup outcomes analysis further demonstrated no significant interaction across subgroups.
conclusionAmong patients with PAF undergoing initial ablation, the addition of empiric SVCI to PVI, compared with PVI alone, did not significantly improve freedom from ATA recurrence. CLINICAL
trial registrationThis study was registered with Chinese Clinical Trials Registry: ChiCTR220005554.
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