American heart journal
October 1, 2026 · via Europe PMC
Rationale and design of a multicenter randomized trial of adjunctive non-pulmonary vein trigger ablation in persistent atrial fibrillation: The EXPORT trial.
Kim D, Lee KY, Park H, +7 more, Pak HN.
AI summary — for doctors, generated from the abstract only
The EXPORT trial will test whether adding non-pulmonary vein trigger ablation to PV isolation lowers arrhythmia recurrence in persistent AF.
What was studied
Design of a multicenter randomized trial of 430 patients with persistent AF refractory to drugs undergoing first ablation, randomized to PVI plus non-PV trigger provocation, mapping and ablation or PVI alone.
Key findings
- Primary endpoint is any atrial arrhythmia of 30 seconds or more after a 3-month blanking period.
- Secondary endpoints include freedom from recurrence off AADs, complications and procedure time.
- Planned sample size is 430 (215 per group).
Clinical relevance
The trial will address whether extra trigger ablation helps in persistent AF where PVI alone is less effective.
Who should care
Limitations
This is a protocol paper with no results, so no efficacy evidence is available yet.
Nothing to change now; await trial results.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Pulmonary vein (PV) isolation in paroxysmal atrial fibrillation (AF) is strongly endorsed with a class IA recommendation for those with symptomatic AF who are refractory to antiarrhythmic drug (AAD) therapy to reduce symptoms, recurrence, and disease progression. However, in persistent AF, the efficacy of PV isolation alone is less pronounced than in paroxysmal AF, underscoring the necessity of adjunctive ablation strategies. Whether ablation of non-PV triggers after PV isolation improves the long-term procedure outcome is unknown. The EXPORT trial aims to evaluate the effects of systematic non-PV trigger ablation over PV isolation alone on freedom from atrial tachyarrhythmia recurrence among participants with persistent AF.
Study design
The EXPORT trial is a multicenter, prospective, superiority, single-blinded, blinded-endpoint, clinical trial. Participants with persistent AF refractory to AAD therapy undergoing first-time AF ablation will be randomly assigned to either PV isolation with non-PV trigger provocation, mapping, and ablation or PV isolation alone. The primary endpoint is any documented atrial arrhythmia lasting ≥30 s after a 3-month blanking period following ablation with or without the use of AADs. Key secondary endpoints are freedom from atrial arrhythmia recurrence without AAD use, periprocedural complications, and total procedure time. The estimated total sample size is 430 participants, with 215 participants in each group.
Conclusion
The EXPORT trial will assess the effect of non-PV trigger mapping and ablation with PV isolation on freedom from atrial tachyarrhythmia recurrence in participants with persistent AF.
Trial registration
Clinicaltrials.gov; NCT07197931.
DOI
10.1016/j.ahj.2026.107624
PMID
42822815
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed