{"id":"d792ac9455ff","type":"article","url":"https://hartvaat.nl/2018/09/01/pace-capture-geleide-ablatie-na-contact-force-pvi-dragon-gerandomiseerde-trial/","title":"Pace-capture-geleide ablatie na contact-force PVI: DRAGON gerandomiseerde trial","title_en":"Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/eux319","source_url":"https://doi.org/10.1093/europace/eux319","authors":["Masaharu Masuda","Masashi Fujita","Osamu Iida","Shin Okamoto","Takayuki Ishihara","Kiyonori Nanto","Takashi Kanda","Akihiro Sunaga","Takuya Tsujimura","Yasuhiro Matsuda","Takuya Ohashi","Masaaki Uematsu"],"significance":5,"published":"2018-09-01","source_date":"2018-09-01","image":"","kennis":[],"congress":"","summary_en":"The DRAGON randomized trial tested whether additional pace-capture-guided ablation after contact-force-guided PVI improves AF ablation outcomes, evaluating a gap-targeting strategy for more complete pulmonary vein isolation.","created":"2026-07-03T10:27:27Z","updated":"2026-07-03T13:26:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"DRAGON gerandomiseerde trial naar aanvullende pace-capture-geleide ablatie na contact-force-geleide pulmonaalvene-isolatie bij AF.","abstract_original":"AIMS: Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. METHODS AND RESULTS: A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80). Follow-up of at least 1 year commenced with serial 24 h Holter and symptom-triggered ambulatory monitoring. There was no significant difference in acute PV reconnection rates during a 20 min waiting period after the last ablation or adenosine infusion testing between the PC and the control groups (per patient, 21% vs. 27%, P = 0.27; per AF-trigger PV, 5.9% vs. 7.3%, P = 0.70; and per non-AF-trigger PV, 7.1% vs. 7.4%, P = 0.92). Atrial tachyarrhythmia-free survival rates off antiarrhythmic drugs after the initial session were comparable at 19.3 ± 6.2 months between the two groups (82% vs. 80%, P = 0.80). Among 22 patients who required a second ablation procedure, there was no difference between the PC and the control groups in the PV reconnection rates at both previously AF-trigger (29% vs. 43%, P = 0.70) and non-AF-trigger PVs (18% vs. 19%, P = 0.88). CONCLUSIONS: Pace-capture-guided ablation performed after contact-force-guided PV isolation demonstrated no improvement in PV isolation durability or rhythm outcome."}