Circumferential pulmonary vein isolation with adjunctive linear ablation vs. circumferential pulmonary vein isolation alone for long-standing persistent atrial fibrillation: a randomized pilot study.

ABSTRACT:

Aims

This 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 results

In 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 mo

SUBMITTER: Zhu Y 

PROVIDER: S-EPMC12395555 | biostudies-literature | 2025 Aug

REPOSITORIES: biostudies-literature