Aggressive ablation improves outcomes for atrial fibrillation patients

Aggressive ablation has been found to yield better results than regular ablation for patients with persistent atrial fibrillation (AF). This was shown in a study involving over 4,800 patients who underwent catheter ablation in China from 2019 to 2023. The study divided participants into two groups after matching them for similar characteristics. One group received regular ablation, while the other received aggressive ablation. Both groups had similar average ages, with most participants being around 72 years old. The aggressive approach included more extensive treatment methods, such as extensive electrogram-guided ablation. Results showed that patients who had aggressive ablation were more likely to remain free of AF and atrial tachycardia (AT) after 12 months. Specifically, 66.2% of these patients reported no recurrence, compared to 59.3% in the regular ablation group. Those in the aggressive group also experienced higher rates of AF termination during procedures. The study indicated that aggressive ablation leads to improved survival rates without AF or AT. Moreover, there were no significant differences in adverse effects between the two methods. Despite the promising findings, researchers noted limitations. The study's retrospective design meant it lacked randomization and may have affected the accuracy of outcomes. The follow-up period was also limited to 12 months, which may not capture late recurrences of AF. The study was led by Dr. Kaige Li from Shanghai Chest Hospital and was published online on March 6, 2025. It was funded by the National Natural Science Foundation of China. The authors stated they had no conflicts of interest.