Innovative Digital Twin-Guided Ablation Significantly Reduces Arrhythmia Recurrence in Persistent Atrial Fibrillation

A groundbreaking clinical trial has demonstrated that integrating digital twin technology into ablation procedures markedly improves outcomes for patients with persistent atrial fibrillation (AF). Presented at the ESC Congress 2025 and published in Nature Medicine, the study reveals that personalized ablation guided by digital twin simulations leads to higher rates of arrhythmia-free survival.

Atrial fibrillation affects approximately one in three adults globally, with persistent forms of the condition often resistant to standard treatments such as anti-arrhythmic drugs (AADs). When these medications fail, catheter ablation—a procedure that destroys problematic heart tissue—is typically employed. However, traditional ablation techniques, like pulmonary vein isolation (PVI), have limitations, especially in persistent AF cases.

The innovative approach developed by researchers involves creating a digital twin of the patient's heart before the ablation. This simulation identifies specific areas within the atrium, called phase singularity (PS) points, which are likely to sustain AF. In the randomized CUVIA-PRR trial conducted across four South Korean centers, patients were assigned either to standard PVI or to PVI combined with digital twin-guided ablation targeting these PS points.

Participants in the digital twin-guided group had pre-procedure maps generated to locate stable PS points. Those whose PS points were ablated showed significantly better outcomes at 18 months—77.9% remained free from atrial arrhythmias compared to 59.5% in the conventional PVI group. Moreover, the rate of arrhythmia-free survival without additional medication was also higher in the tailored ablation group.

Importantly, the study reported no increase in procedure duration or complication rates for the digital twin-guided technique. The average procedure time was comparable between groups, underscoring the safety and efficiency of this personalized method.

Professor Daehoon Kim, principal investigator, emphasized that this tailored approach targets the individual mechanisms underlying AF, improving success rates without extending procedure time or increasing risks. He highlighted that previous uniform approaches were less effective, and AI-guided ablation offers a promising path for enhancing treatment outcomes.

This research underscores the potential of artificial intelligence and personalized medicine in transforming cardiac care, offering new hope for patients with persistent AF who have exhausted traditional treatment options.

Source: https://medicalxpress.com/news/2025-09-digital-twin-ablation-arrhythmia-recurrence.html