ALID score for treatment-effect heterogeneity of adjunctive low-voltage area ablation in persistent atrial fibrillation: A post hoc analysis of SUPPRESS-AF.
Int J CardiolJul 16, 2026 (epub)
Clinical ResearchCardiology
Yasuyuki Egami, Haya Matsubara, Ryo Muroya et al.
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In 30 seconds
This post-hoc analysis of the SUPPRESS-AF randomized controlled trial evaluated the ALID score's ability to predict treatment-effect heterogeneity of adjunctive low-voltage area (LVA) ablation in patients with persistent atrial fibrillation and mapped LVA >5 cm². The study found that adjunctive LVA ablation increased recurrence in low-score patients (HR 3.92) and reduced recurrence in high-score patients (HR 0.48).
Key findings
- In the low-score group, adjunctive LVA ablation increased recurrence (HR 3.92; 95% CI 1.50-10.20).
- In the high-score group, adjunctive LVA ablation reduced recurrence (HR 0.48; 95% CI 0.26-0.86).
- A significant treatment-by-score interaction was observed (P < 0.001).
- A qualitatively similar interaction pattern was noted in the EARNEST-PVI cohort (interaction P = 0.029).
Why it matters
Understanding treatment-effect heterogeneity in persistent atrial fibrillation can help clinicians tailor ablation strategies to individual patient profiles, potentially improving outcomes and reducing unnecessary procedures.