This article is more than 5 years old. Information may no longer be current.
STAR-AF: Combining AF ablation strategies associated with freedom from AF
The combined ablation strategies are also associated with fewer repeat procedures than each individual strategy.
Click Here to Manage Email Alerts
Heart Rhythm Society's 30th Annual Scientific Sessions
The combination of pulmonary vein isolation ablation and complex fractionated electrograms was associated with greater freedom from AF than the respective techniques alone, according to research presented yesterday at Heart Rhythm 2009 in Boston.
Researchers for the STAR-AF trial enrolled 100 patients with high-burden paroxysmal AF and randomly assigned them to undergo either pulmonary vein isolation alone (n=32), ablation of complex fractionated electrograms alone (n=34) or both therapies combined (n=34). The primary endpoint was freedom from any AF >30 seconds at one year.
The researchers reported that all four pulmonary veins were successfully ablated in 90% of patients who underwent pulmonary vein isolation alone. In the group with combined ablation strategies, 94% of patients had all four pulmonary veins isolated; 76% had inducible AF with additional complex fractionated electrograms ablation; and 50% had AF termination.
There were also more repeat procedures in the complex fractionated electrogram ablation group (38%) vs. the pulmonary vein isolation group (25%) or the combined strategy group (12%; P=.04 for comparison). After one procedure, the combined ablation strategies maintained a greater freedom from AF (74%) compared with the pulmonary vein isolation group (47%) and the complex fractionated electrogram ablation group (29%; P=.01 for comparison). The combined strategies also maintained higher freedom from AF after a second procedure compared with the individual strategies (P=.01). No mortality was reported.
“The combined strategy requires fewer repeat procedures compared with either strategy alone, and complex fractionated electrogram ablation alone is associated with the highest recurrence rate, as well as the highest number of repeat procedures,” said Atul Verma, MD, an electrophysiologist at Southlake Regional Health Center in Ontario, Canada, during the presentation. “The benefit of the combined strategy may be more pronounced in persistent AF, although this was a subgroup analysis based on very small numbers.” – by Eric Raible
For more information:
- Verma A. LBCT I. Presented at: Heart Rhythm 2009; May 13-16, 2009; Boston.
More HRS meeting highlights >>