TAILORED-AF

Artificial Intelligence for Individualized Treatment of Persistent Atrial Fibrillation: a Randomized Controlled Trial

Paziente / Popolazione Intervento / Esposizione Confronto Esito

In 370 patients with drug-refractory persistent atrial fibrillation (187 tailored, 183 anatomical), AI-guided ablation of spatio-temporal electrogram dispersion areas in addition to pulmonary vein isolation improved freedom from atrial fibrillation at 12 months after a single procedure compared with pulmonary vein isolation alone.

N
370
Disegno
Multicentre double-blind superiority RCT
Esito
Freedom from documented AF, with or without antiarrhythmic drugs, at 12 months after a single ablation procedure
Rilevanza
2
RisultatoFreedom from AF 88% vs 70% (log-rank P<0.0001 for superiority); no significant difference in freedom from any atrial arrhythmia after one procedure; safety composite did not differ; procedure and ablation times twice as long in the tailored arm.
Deisenhofer I, et al. Nat Med. 2025;31(4):1286-1293. 10.1038/s41591-025-03517-w
Discussione e critica

The first randomised trial in which an AI-identified ablation target beat pulmonary vein isolation alone in persistent AF. The gain was specific to AF: freedom from any atrial arrhythmia was not different, because tailored ablation can leave organised atrial tachycardias that need a further procedure, and the procedures took twice as long. Follow-up was 12 months after a single procedure.