# Vrouwen met persisterend AF: PVI alleen is onvoldoende

*geplaatst 2025-10-31 · 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/euaf281 · https://hartvaat.nl/2025/10/31/vrouwen-met-persisterend-af-pvi-alleen-is-onvoldoende/*

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.

## English: 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.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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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/euaf281. Bijgewerkt 2026-07-03T13:30:56Z. 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.