Pulmonary vein isolation using segmental versus electroanatomical circumferential ablation for paroxysmal atrial fibrillation: over 3-year results of a prospective randomized study.

PURPOSE: We tested the hypothesis that electroanatomic pulmonary vein (PV) antra encircling for the PV isolation will improve the outcome in treatment of paroxysmal atrial fibrillation (PAF), compared with segmental PV isolation.

METHODS

Fifty-four patients underwent segmental PV isolation (group 1) and 56 patients circumferential PV isolation (group 2) for symptomatic PAF in a randomized study.

RESULTS

Following single ablation procedure, at the 48 +/- 8 month follow-up, 30 (56%) and 32 (57%) patients in groups 1 and 2 remained free of arrhythmia (P = 0.41). After repeat ablation, 43 (80%) and 45 (80%) patients in groups 1 and 2 were free of arrhythmia without antiarrhythmic drugs (AADs); 48 (89%) and 51 (91%) patients in groups 1 and 2 did not have arrhythmia recurrences without or with AADs.

CONCLUSION

This study demonstrates no advantage in long-term arrhythmia-free clinical outcome after circumferential PV isolation in patients with frequent PAF.