Abstract 16225: Durability of Left Atrial Linear Ablation and Clinical Outcome After Catheter Ablation for Persistent Atrial Fibrillation
Introduction: It is not clear whether bidirectional block (BDB) of linear ablations reduces AF recurrence after RFCA.
Hypothesis: We hypothesized that BDB of linear ablation has prognostic significance after RFCA for persistent AF (PeAF).
Methods: Among 1793 consecutive patients in Yonsei AF ablation Cohort, we included 398 patients with PeAF (75.6% male, 59.8±10.3years old) who underwent catheter ablation with consistent ablation protocol of Dallas lesion set: CPVI, cavotricuspid isthmus ablation (CTI), roof line (RL), postero-inferior line (PIL), and anterior line (AL).
Results: BDB rates of de novo ablation lines were 100% in CPVI, 100% in CTI, 84.7% in RL, 44.7% in PIL, and 63.6% in AL. During the 29.0±18.4 months of follow-up, 31.7% (126/398) showed clinical recurrence. Left atrial posterior wall (LAPW) isolation (BDBs of RL and PIL) was independently associated with lower clinical recurrence (HR 0.68, 95% CI 0.47~0.98, p=0.041, Log-rank p=0.017), whereas those with BDB of RL or AL were not (Log-rank p=0.178 for RL, p=0.764 for AL). Among 52 patients who underwent repeat procedures (23.0±16.1 months after de novo procedure), maintenance rate of LAPW isolation was 75% (18/24), and BDB maintenance rates for CTI, RL, and AL were 94.2% (49/52), 75% (33/44), and 72.4% (21/29), respectively.
Conclusions: Although PIL crosses esophageal contact area, LAPW isolation is important for the better clinical outcome in catheter ablation with linear ablation strategy for the patients with PeAF.
Author Disclosures: T. Kim: None. J. Park: None. J. Uhm: None. J. Kim: None. B. Joung: None. M. Lee: None. H. Pak: None.
- © 2016 by American Heart Association, Inc.