Adding six short lines on pulmonary vein isolation circumferences reduces recurrence of paroxysmal atrial fibrillation: Results from a multicenter, single-blind, randomized trial

BACKGROUND Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) is associated with a non-negligible long-term recurrence rate.& nbsp;OBJECTIVES The purpose of this study was to investigate whether PVI combined with 6 short ablation lines on the PVI circumferences (PVI+6L group) yields higher success rates than PVI alone (PVI group).& nbsp;METHODS In this multicenter, single-blind, randomized trial, a total of 390 patients with paroxysmal AF were randomly assigned to the PVI group (n = 193) or the PVI+6L group (n = 197). The primary endpoint was freedom from AF/atrial tachycardia recurrence between 91 and 365 days. Secondary endpoints included AF burden, procedural parameters, and complications.& nbsp;RESULTS Freedom from atrial tachyarrhythmia was achieved in 160 of 197 patients (81.2%) in the PVI+6L group and 142 of 193 patients (73.6%) in the PVI group (hazard ratio 0.61; 95% confidence interval 0.39-0.97; P = .040). Mean AF burden tended to be lower in the PVI+6L group compared to the PVI group (1.95% vs 0.53%, P = .097). Procedural and ablation times were slightly longer in the PVI+6L group than in the PVI group (130 +/- 25 minutes vs 121 +/- 28 minutes; P = .002; and 46 +/- 14 minutes vs 41 +/- 16 minutes, P = .001, respectively). X-ray exposure was similar (60 +/- 54 seconds vs 61 +/- 60 seconds; P = .964). Complications occurred in 3 patients (1.6%) in the PVI group and 3 patients (1.5%) in the PVI+6L group.& nbsp;CONCLUSION In patients with paroxysmal AF undergoing catheter ablation, adding 6 short ablation lines on the PVI circumferences could reduce the AF recurrence rate. (C)2021 Heart Rhythm Society. All rights reserved

Automated summary

This study aimed to investigate the treatment effect of combining PVI with 6 short ablation lines on paroxysmal AF patients. The results showed that the proportion of patients with freedom from atrial tachyarrhythmia was significantly higher in the PVI+6L group compared to the PVI group, and the mean AF burden was reduced, but the procedural and ablation times were slightly longer, and the X-ray exposure was similar between the two groups. Therefore, adding 6 short ablation lines on the PVI circumferences can effectively reduce the AF recurrence rate.