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Updated: Feb 28, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients With Persistent Atrial Fibrillation
Hee Tae Yu1, Jaemin Shim1, Junbeom Park1
1From the Yonsei University Health System, Seoul, Republic of Korea (H.T.Y., I.-S.K., T.-H.K., J.-S.U., B.J., M.-H.L., H.-N.P.); Korea University Cardiovascular Center, Seoul, Republic of Korea (J.S., Y.-H.K.); and Ewha Womans University, Seoul, Republic of Korea (J.P.).
Background:
Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF.
Methods And Results:
We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60.4±10.1 years old) who underwent catheter ablation for nonvalvular AF at 3 tertiary hospitals. The participants were randomly assigned to 2 groups: CPVI alone (n=59) or CPVI plus linear ablation (CPVI+Line; posterior box+anterior line, n=54). Compared with the CPVI+Line, CPVI alone required shorter procedure (187.2±58.0 versus 211.2±63.9 min; P=0.043) and ablation times (4922.1±1110.5 versus 6205.7±1425.2 s; P<0.001) without difference in procedure-related major complication (3% versus 2%; P=0.611). Antiarrhythmic drug utility rates after ablation were not different between the 2 groups (22% versus 30%; P=0.356). Overall, AF-free survival (log-rank; P=0.206) and AF and antiarrhythmic drug-free survival (log-rank; P=0.321) were not different between groups.
Conclusions:
CPVI alone is an effective rhythm control strategy with a shorter procedure time in persistent AF patients converted to paroxysmal AF compared with CPVI with linear ablation.
Clinical Trial Registration:
URL: https://www.clinicaltrials.gov. Unique identifier: NCT02176616.
