# nMARQ, PVAC en thoracoscopische ablatie bij paroxysmaal AF: gerandomiseerde trial

*geplaatst 2018-11-01 · Atriumfibrilleren · 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/eux267 · https://hartvaat.nl/2018/11/01/nmarq-pvac-en-thoracoscopische-ablatie-bij-paroxysmaal-af-gerandomiseerde-trial/*

Eerste gerandomiseerde trial die drie AF-ablatietechnieken vergeleek: nMARQ, PVAC en thoracoscopische ablatie.

## English: Results of the first investigator-initiated randomized clinical trial of nMARQTM, PVACTM, and thoracoscopic ablation for paroxysmal atrial fibrillation.

This first randomized comparison of three AF ablation techniques (nMARQ, PVAC, and thoracoscopic ablation) provided head-to-head data on these different energy delivery systems for pulmonary vein isolation.

## Abstract (original, from the publication)

AIMS: To investigate the effect of minimally invasive thoracoscopic surgical ablation and nMARQ irrigated multi-electrode phased radiofrequency (RF) ablation to treat paroxysmal atrial fibrillation (AF) compared with PVAC multi-electrode phased RF ablation, with beat-to-beat device-derived Holter monitoring throughout the study duration. METHODS AND RESULTS: An investigator-initiated prospective trial of patients with paroxysmal AF randomized (1:1:1) to initial surgical, nMARQ or PVAC ablation. All patients had continuous beat-to-beat monitoring with an ILR or pacemaker to evaluate and document AF recurrence. There was a strong trend (P = 0.050) toward difference in AF outcome, with surgical AF ablation more efficacious than catheter ablation. At one year, the proportion of patients with less than 1% AF burden after one procedure and off all antiarrhythmic drugs was 63, 56, and 90% for PVAC, nMARQ and surgical ablations respectively. There were significantly more repeat ablations in the catheter ablation groups (P = 0.008): 25% PVAC, 27% nMARQ, 0% surgery. However, 7 of 20 (35%) of patients undergoing surgical ablation suffered a procedural complication, including two sternotomies for bleeding and one death. This was higher than for catheter ablation (P < 0.001). Surgical ablation took longer to perform (P < 0.001) and had a longer hospital admission (P < 0.001) than catheter ablation. CONCLUSION: Surgical AF ablation required significantly fewer repeat procedures than catheter ablation, and there was a clear trend towards improved arrhythmia outcome. However, it was associated with a significantly higher rate of procedural complications. Surgical ablation for paroxysmal AF is promising, however more prospective outcome data is required. CLINICAL TRIAL REGISTRATION: NCT01504451, http://clinicaltrials.gov/show/NCT01504451.

Auteurs: Conn Sugihara, Steve Furniss, Jonathan Hyde, Michael Lewis, Neil Sulke

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Bron: 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, https://doi.org/10.1093/europace/eux267. Bijgewerkt 2026-07-03T13:26:49Z. 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.