Abstract 19736: Patients With Paroxysmal and New Onset Persistent Atrial Fibrillation and Severe Left Atrial Scarring: Outcome With and Without Ablation of Extra Pulmoany Veins Triggers
Introduction: Severe left atrial (LA) scarring has been shown to be an independent predictor of ablation failure for atrial fibrillation. The aim of this study was to compare the outcome in patients with paroxysmal or new onset persistent and severe LA scarring identified by 3D mapping undergoing LA ablation.
Methods: 131 consecutive patients with paroxysmal and new onset atrial fibrillation have been enrolled in this study. In all patients severe (≥ 60%) LA scarring was diagnosed by 3D voltage mapping. The patients, depending on the operator choice underwent ablation of the pulmonary vein antrum alone (n=65 group 1) or ablation of the pulmonary vein antrum associated with ablation of extra PV triggers identified by high dose of isoproterenol ( n=66 group 2). Patients were followed up for at least one year with Holter monitoring and event recorders.
Results: No significant statistical difference was present between the groups in regards to baseline clinical characteristics. After a single procedure, freedom from AF off AADs at a mean follow up of 19 ± 5 months was 29% ( 19 pts) in group 1, and 71% ( 47 pts) in group 2. Kaplan-Meier log-rank test indicated that the cumulative probability of AF-free survival was significant higher in group 2 (log-rank p <0.001, figure).
Conclusions: These results suggest that in patients with paroxysmal/persistent AF and severe LA scarring ablation of extra PV triggers is necessary to improve freedom from AF.
- © 2010 by American Heart Association, Inc.