Pulmonary vein isolation with or without empiric superior vena cava isolation in patients undergoing ablation for paroxysmal atrial fibrillation: the randomized ESVCI-AF trial.

ABSTRACT:

Aims

The 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 results

A 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 gro

SUBMITTER: Shen W 

PROVIDER: S-EPMC12448917 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature