Combined LAPVI improved sinus rhythm maintenance versus PVI alone in persistent AF patients.

This randomized controlled trial enrolled 228 patients with persistent atrial fibrillation to compare the effectiveness of combined Left Atrial Posterior Wall Linear Ablation and Pulmonary Vein Isolation (LAPVI) versus PVI alone. The study assessed outcomes at 6 months, 1 year, and 2 years. Safety data, including adverse events and tolerability, were not reported in this publication.

At two years, sinus rhythm maintenance was achieved in 74.77% of the LAPVI group compared to 54.7% in the PVI group (P = 0.002). Recurrence of paroxysmal AF occurred in 11.71% of the LAPVI group versus 24.79% in the PVI group (P < 0.05). Similarly, persistent AF recurrence was 9.01% with LAPVI versus 20.51% with PVI (P < 0.05). Antiarrhythmic drug use was significantly reduced in the LAPVI group at each follow-up interval (P < 0.05).

No safety data, discontinuations, or specific adverse events were reported. The study design and population are clearly defined, but the absence of safety reporting limits the ability to assess the risk-benefit profile. While the results indicate superior rhythm control and reduced medication dependence with LAPVI, the lack of reported safety outcomes and unreported funding or conflict of interest information necessitates cautious interpretation before changing clinical practice.