Pulmonary Vein Isolation With Versus Without Continued Antiarrhythmic Drugs in Persistent Atrial Fibrillation

Summary

In the POWDER 1 study, paroxysmal atrial fibrillation (AF) patients undergoing conventional contact force (CF)-guided PVI were investigated. Patients were randomized between continuing previously ineffective antiarrhythmic drug therapy (ADT) or stopping ADT at the end of the blanking period. This trial, showed an added value of ADT after ablation (in support of 'hybrid rhythm control' as an alternative treatment strategy for AF in some patients). In the POWDER 2 trial, an analogue study in persistent AF patients will be performed. All patients will undergo ablation index (AI)- and IL distance (ILD)-guided PVI (just like in VISTAX trial) and continue previously ineffective ADT during the blanking period. 'PVI only' was chosen as the ablation strategy according to the STAR AF trial findings.

Timeline

Start

2018-02-26

Primary completion

2022-05-30

Completion

2022-06-30

Publications

• Demolder A, O'Neill L, El Haddad M, Scherr D, Vijgen J, Wolf M, Berte B, Bisbal F, Johannessen A, Rivero-Ayerza M, De Potter T, De Becker B, Polain de Waroux JL, Knecht S, Tavernier R, Duytschaever M. No Effect of Continued Antiarrhythmic Drug Treatment on Top of Optimized Pulmonary Vein Isolation in Patients With Persistent Atrial Fibrillation: Results From the POWDER-AF2 Trial. Circ Arrhythm Electrophysiol. 2023 Nov;16(11):e012043. doi: 10.1161/CIRCEP.123.012043. Epub 2023 Nov 3.

Drugs

Indications