{"id":"433e6c0b91ca","type":"article","url":"https://hartvaat.nl/2025/10/31/vrouwen-met-persisterend-af-pvi-alleen-is-onvoldoende/","title":"Vrouwen met persisterend AF: PVI alleen is onvoldoende","title_en":"Women with persistent atrial fibrillation need more than pulmonary vein isolation: personalised extra-pulmonary vein ablation strategy vs. pulmonary vein isolation alone in the TAILORED-AF 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/euaf281","source_url":"https://doi.org/10.1093/europace/euaf281","authors":["Isabel Deisenhofer","Julien Seitz","Marie-Sophie Nguyen-Tu","Sabine Lotteau","Clément Bars","Jean-Paul Albenque","Sonia Busch","Edouard Gitenay","Stavros Mountantonakis","Antoine Roux","Jérôme Horvilleur","Babe Bakouboula","Saumil Oza","Selim Abbey","Guillaume Theodore","Antoine Lepillier","Yves Guyomar","Francis Bessière","Jaap Jan Smit","Anil Rajendra","Daniel H Cooper","Haroon Rashid","Tom De Potter","Christian De Chillou","Seth Goldbarg","Atul Verma","Gustavo Morales","Paola Milpied","John D Hummel","Jérôme Kalifa"],"significance":6,"published":"2025-10-31","source_date":"2025-10-31","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/ritmecontrole-af/"],"congress":"","summary_en":"This study showed that women with persistent AF benefit more from personalized extended ablation beyond PVI than from PVI alone, identifying a sex-specific ablation strategy that addresses the different AF substrate in women.","created":"2026-07-03T10:31:57Z","updated":"2026-07-03T13:30:56Z","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":"Studie toonde dat vrouwen met persisterend AF meer baat hebben bij gepersonaliseerde uitgebreide ablatie dan PVI alleen. Sekseverschillen in AF-substraat vereisen een aangepaste strategie.","abstract_original":"AIMS: There is still conflicting evidence if women with persistent atrial fibrillation (AF) profit from a pulmonary vein isolation (PVI) plus strategy. We evaluated the efficacy of a spatio-temporal dispersion-targeted ablation strategy in women from the TAILORED-AF trial. METHODS AND RESULTS: In TAILORED-AF, 370 patients were randomised to either a personalised, artificial intelligence (AI)-guided tailored ablation or to PVI-only. AF substrate mapping data and 12-month ablation outcomes were compared between women and men. Overall, 21% patients were female (70.4 ± 6.9 vs. 64.5 ± 8.5 years for men, P < 0.001). While spatio-temporal dispersion extent was similar between groups, left atrial low-voltage surface area (<0.2 mV) was significantly larger in women (P < 0.01). In women, the single-procedure freedom from AF (76% vs. 50%, log-rank P < 0.001) and any atrial arrhythmia (56% vs. 38%, log-rank P < 0.05) were significantly superior to PVI alone with a tailored procedure. In the PVI-only group, the single-procedure freedom from AF (50% vs. 70%, log-rank P < 0.001) and any atrial arrhythmia (38% vs. 61%, log-rank P < 0.001) were significantly lower in women. After a tailored ablation, no significant differences were observed between women and men regarding freedom from AF (76% vs. 91%, log-rank P = 0.07) or any atrial arrhythmia (56% vs. 62%, log-rank P = 0.69) free survival. CONCLUSION: Compared to men, PVI-only in women with persistent AF leads to a significantly lower freedom from atrial arrhythmia. A personalised spatio-temporal dispersion-targeted ablation strategy led to a higher rate of freedom from any atrial arrhythmia than standard PVI after a single procedure in women and comparable outcomes between women and men. REGISTRATION IDENTIFICATION: clinicaltrials.gov NCT04702451."}