RETRACTED: Impact of Rotor Ablation in Nonparoxysmal Atrial Fibrillation Patients Results From the Randomized OASIS Trial [J Am Coll Cardiol 2016;68:274–82]
Authors: Carola Gianni
Patrick M Hranitzky
Prasant Mohanty
Philipp Halbfass
G Joseph Gallinghouse
Tamara Metz
Sanghamitra Mohanty
Rong Bai
Javier E Sanchez
Andrea Natale
Chintan Trivedi
Rodney Horton
Amin Al-Ahmad
Gery Tomassoni
Shane Bailey
John David Burkhardt
Luigi Di Biase
Thomas Deneke
Journal: Journal of the American College of Cardiology (2016)
Discipline: CLINICAL MEDICINE
Keywords: FIRM-guided ablation; PVAI; non-PV triggers; nonparoxysmal AF; rotors.
Affiliations: Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas., Department of Cardiology, Cardiovascular Center, Bad Neustadt, Germany., Department of Cardiology, Lexington Cardiology at Central Baptist, Lexington, Kentucky., Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Electrophysiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Cardiology, Cardiovascular Center, Bad Neustadt, Germany., Department of Electrophysiology, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Cardiology, Lexington Cardiology at Central Baptist, Lexington, Kentucky; Department of Electrophysiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, California; Interventional Electrophysiology, Scripps Clinic, La Jolla, California; Internal Medicine, Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Division of Cardiology, Stanford University, Stanford, California; Department of Internal Medicine, Dell Medical School, University of Texas, Austin, Texas.

Abstract:  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 &lt; 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 &lt; 0.0001). Group 3 patients experienced higher success compared with groups 1 (p &lt; 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). 

Retracted: Yes

PubPeer comments:
 Some images in Figure 7 appear to be repeated. Could the authors confirm whether this is intentional? *** ![file] *** ![file] , 
 #1 Thank you so much for helping us to point out the error. We have checked our original data of invasion images of Figure 7 and found that this error was made while arranging the data. We apologize for such an error that should not being made; however, we are sure that this error does not affect the conclusion of the study. Weu2019ll contact the Editorial office to correct it and post the decision made as soon as possible. Thank you for your comments. The original data for Figure 7 are shown below. ![file] ,