Abstract 16027: Impact of Ancillary Ablation Strategies on One Year Outcomes of AF Intervention
Background: Despite attempts at issue clarification, there remains considerable controversy over the need for ancillary interventions beyond pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). The impact of the extent of ancillary interventions has not been established.
Methods: Because of this, outcomes from the Mayo Ablation Registry of 371 patients with AF were derived in a 4 years prospectively collected data. These patients underwent a total of 381 procedures. These patients had atrial fibrillation of 6.5±5.8 year duration. 202 (54%) had paroxysmal, 125 (35%) had persistent, and 44 (12%) had long-standing persistent atrial fibrillation. The ablation was performed as Lasso guided pulmonary vein isolation (PVI) alone, Wide area circumferential ablation (WACA) alone, WACA plus left atrial roof (LAR) and mitral isthmus (MIS) ablation, WACA plus more than 3 linear lesions ablation. The 1 year outcomes were established.
Results: The outcome of intervention as a finder of complexity of the procedure in these patients was as follows: Patients who received WACA plus LAR/MIS ablation has more recurrence AF in ≤ 90 days compared with WACA alone (p<0.01), and has more post ablation atrial flutter then the others (p<0.01). There was no difference in outcomes of AF at one year after ablation in all groups.
Conclusion: These data suggest that WACA alone has better outcome than PVI alone or WACA with extensive lesions. The addition of extensive linear lesion creation does decrease recurrent AFL.
- © 2012 by American Heart Association, Inc.