SUPERIOR: sacubitril/valsartan linked to fewer AFib recurrences after ablation than valsartan alone
In a 320-patient randomized trial in China presented 8 November 2026 at AHA Scientific Sessions, adults with hypertension who started sacubitril/valsartan after atrial fibrillation ablation had documented arrhythmia recurrence in 18% at 12 months versus 28.3% with valsartan, despite similar blood-pressure drops; the findings are a preliminary, non-peer-reviewed abstract.
The SUPERIOR trial, presented on 8 November 2026 as late-breaking science at the American Heart Association’s Scientific Sessions in Chicago, asked whether the choice of blood-pressure drug after atrial fibrillation (AFib) ablation affects whether the arrhythmia returns.
Design
Researchers led by Wei Zhang of the Shanghai Institute of Hypertension at Ruijin Hospital (Shanghai Jiao Tong University) enrolled 320 patients with AFib and hypertension (clinic blood pressure above 130/80 mm Hg) who had catheter ablation at three hospitals in China between February 2023 and January 2025. Average age was 68; 41.2% were women; 66.6% had paroxysmal AFib. After ablation, 161 were randomized to sacubitril/valsartan 100 mg once daily and 159 to valsartan 80 mg once daily (an active comparator, since all needed blood-pressure treatment). Rhythm was checked with handheld single-lead ECGs at home plus 12-lead ECG and 24-hour Holter at 1, 3, 6 and 12 months.
Results
- Documented recurrence of atrial tachyarrhythmias at 12 months: 18% with sacubitril/valsartan versus 28.3% with valsartan.
- Clinic systolic blood pressure fell by about 10 mm Hg in both groups, with no significant difference in 24-hour ambulatory reduction.
Zhang said the type of blood-pressure treatment after ablation may matter as much as how far pressure is lowered, while stressing that neither ablation nor medication alone is enough.
Limitations
This is a research abstract, not yet a peer-reviewed paper, so results are preliminary. The trial was open-label (although recurrences were adjudicated by a blinded team). Rhythm monitoring was intermittent, so brief or silent episodes may have been missed. It was small and limited to older adults with hypertension in China, so results may not apply to younger people, those without hypertension or other countries. Funding came from Chinese government and hospital research programs. This is not personal medical advice — do not change medicines without your doctor.
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