RETRACTED: Impact of Rotor Ablation in Nonparoxysmal Atrial Fibrillation Patients Results From the Randomized OASIS Trial [J Am Coll Cardiol 2016;68:274–82]
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Background Nonrandomized studies have reported focal impulse and rotor modulation (FIRM)-guided ablation to be superior to pulmonary vein antrum isolation (PVAI) for persistent atrial fibrillation and long-standing persistent atrial fibrillation.Objectives This study sought to compare efficacy of FIRM ablation with or without PVAI versus PVAI plus non-PV trigger ablation in randomized persistent atrial fibrillation and long-standing persistent atrial fibrillation patients.Methods Nonparoxysmal atrial fibrillation (AF) patients undergoing first ablation were randomized to FIRM only (group 1), FIRM + PVAI (group 2) or PVAI + posterior wall + non-PV trigger ablation (group 3). Primary endpoint was freedom from atrial tachycardia/AF. The secondary endpoint was acute procedural success, defined as AF termination, ≥10% slowing, or organization into atrial tachycardia.Results A total of 113 patients were enrolled at 3 centers; 29 in group 1 and 42 each in groups 2 and 3. Group 1 enrollment was terminated early for futility. Focal drivers or rotors were detected in all group 1 and 2 patients. Procedure time was significantly shorter in group 3 versus groups 1 and 2 (p < 0.001). In groups 1 and 2, acute success after rotor-only ablation was achieved in 12 patients (41%) and 11 (26%), respectively. After 12 ± 7 months' follow-up, 4 patients (14%), 22 (52.4%), and 32 (76%) in groups 1, 2, and 3, respectively, were AF/atrial tachycardia-free while off antiarrhythmic drugs (log-rank p < 0.0001). Group 3 patients experienced higher success compared with groups 1 (p < 0.001) and 2 (p = 0.02).Conclusions Outcomes were poor with rotor-only ablation. PVAI + rotor ablation had significantly longer procedure time and lower efficacy than PVAI + posterior wall + non-PV trigger-ablation. (Outcome of Different Ablation Strategies in Persistent and Long-Standing Persistent Atrial Fibrillation [OASIS]; NCT02533843).
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Adenosine testing to identify patients in need of additional ablation remains controversial after evaluation in several reports.
“Adenosine testing to identify patients in need of additional ablation remains controversial after evaluation in several reports.739,[742][743][744]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [739]
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References 32 · Cited by 62
- Authors
- Mohanty, S., Gianni, C., Mohanty, P., Halbfass, P., Metz, T., Trivedi, C., Deneke, T., Tomassoni, G., Bai, R., Al-Ahmad, A., Bailey, S., Burkhardt, J. D., Gallinghouse, G. J., Horton, R., Hranitzky, P. M., Sanchez, J. E., Di Biase, L., & Natale, A.
- Affiliations
- St David's Medical Center (US)
- Central Baptist Hospital (US)
- Capital Medical University (CN)
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 68
- Issue
- 3
- Pages
- 274-282
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2513740829
- Cited by
- 62
- References
- 32
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 11 · 2018: 4 · 2017: 16 · 2016: 14
- FWCI
- 12.34
- Type
- journal article
- Language
- en
- Status
- Retracted
- Update notices
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- non-paroxysmal atrial fibrillation, pulmonary vein antrum isolation, persistent atrial fibrillation, long-standing persistent atrial fibrillation, atrial tachycardia, OASIS trial, retraction, atrial fibrillation ablation outcomes, procedural success
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