Preventive pulmonary vein isolation in patients with cavotricuspid isthmus ablation: Prevent-af study I

Background. Although catheter ablation of isthmus-dependent atrial flutter (AFL) is extremely successful at eliminating the target arrhythmia, many patients subsequently experience a new onset of atrial fibrillation (AF) due to shared mechanisms. The development of AF may necessitate additional interventions and expose patients to longterm risks. Objective. The study was designed to test a hypothesis whether it is possible to keep AF down during cavotricuspid isthmus (CTI) ablation. Methods. This prospective blind randomized study included 50 patients with detected AFL, without AF in the medical history. The patients were randomized to undergo either CTI ablation alone or CTI with concomitant pulmonary vein isolation (PVI). All patients received an implantable loop recorder (ILR) during the ablation procedure. Results. CTI ablation was successful in all 50 patients. PVI was effective in all 25 patients randomized to CTI+PVI group, with no complications recorded in both groups. The procedure (p