A Discussion of Pulmonary Vein Isolation vs Sham Intervention in Symptomatic Atrial Fibrillation (The Lead #77)-The Lead Episode 77 Video

Video Transcription

Video Summary

The SHAM-PVI randomized clinical trial was discussed by Dr. Janice Chu, Dr. Prash Sunders, and Dr. Chris Chung. The study examined the efficacy of pulmonary vein isolation (PVI) for atrial fibrillation (AF) using cryoablation versus a sham procedure. Conducted at two UK sites with 126 patients, it included those with symptomatic paroxysmal or persistent AF who had failed antiarrhythmic drugs or had intolerance issues. The primary result showed a significant reduction in AF burden, from 78.5% to 18.2% in the PVI group, compared to 78.2% to 43% in the sham group. Quality of life metrics also favored PVI. Despite some limitations such as the small study size, lack of diverse ablation techniques, and blinding issues, this study reinforces the efficacy of PVI in reducing AF burden and improving quality of life. Further research is anticipated to solidify these findings.

Keywords

pulmonary vein isolation

atrial fibrillation

cryoablation

randomized clinical trial

quality of life