Abstract 2445: Comparison of Atrial Fibrillation Ablation Strategies for Paroxysmal patients presenting to the Electrophysiology Laboratory In atrial fibrillation
BACKGROUND: Whether different ablation strategies affect paroxysmal atrial fibrillation (AF) termination mode and long term cure is unclear. We compared the effect of different ablation strategies on the AF termination and long term success in patients with parox-AF presenting to the electrophysiology laboratory in AF.
METHODS: One hundred and three (103) consecutive patients with parox-AF scheduled for AF ablation presenting in the lab in AF were selected for this study. The patients were randomized to PVAI only (35 pts) versus bi-atrial ablation of the complex fractionated atrial electrograms (CFAE defragmentation) including the coronary sinus (34 pts) versus CFAE followed by PVAI (34 pts) Modes of AF termination were: conversion to SR, organization into AT or persistence of AF requiring cardioversion following ablation.
RESULTS are summarized below: There was no significant difference between the groups in term of sex, age, AF duration, LA size and EF. Follow up after a single procedure with AAD is summarized below
CONCLUSION: Defragmentation alone had the smallest impact on both acute AF termination and one year follow-up cure rate. No difference in terms of acute and chronic success was seen between PVAI alone and PVAI asoociated with defragmentation. This suggests that PV isolation is critical to cure AF in paroxysmal AF and that adjunctive strategies have minimal impact on cure rate and should not be considered in all patients.