Work

Hybrid Biatrial Ablation Versus Catheter Ablation for Patients With Nonparoxysmal Atrial Fibrillation and Enlarged Left Atrium

Year: 2024

Type: article

Abstract: Background: There is no consensus on the optimal ablation strategy for non-paroxysmal atrial fibrillation (NPAF) with enlarged left atrium. We aimed to explore whether hybrid ablation (HA) was superior to catheter ablation (CA) in these patients.Methods: Patients with NPAF and left atrial diameter (LAD) ≥ 45mm underwent hybrid bi-atrial ablation or CA procedure from June 2014 to July 2021 were included in this study. Propensity score matching was applied to select patients in each group. The primary endpoint was to compare the probability of freedom from atrial tachyarrhythmias between HA and CA. Atrial tachyarrhythmia recurrence was defined as any atrial tachyarrhythmias longer than 30s documented by 24-hour Holter monitoring after the 3-month blanking period.Results: After propensity score matching, 52 patients with enlarged left atrium (median LAD: 51mm) were enrolled in each group. The median follow-up was 36 months. The probability of freedom from atrial tachyarrhythmias at 12, 24 and 36 months on anti-arrhythmia drugs (AADs) was 70.1%, 65.4%, and 62.6% in HA group and 34.3%, 29.4%, and 22.0% in CA group, respectively (p<0.001); off AADs was 57.1%, 52.7% and 50.0% in HA group and 25.0%, 16.2% and 11.5% in CA group (p<0.001); off AADs after redo CA was 62.5%, 60.1% and 60.1% in HA group and 30.4%, 25.1%, and 20.9% in CA group, respectively (p<0.001).Conclusion: For patients with NPAF and enlarged left atrium, hybrid bi-atrial ablation was superior to CA in sinus rhythm maintenance even if redo CA was performed.

Source: Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery

DOI: 10.1177/15569845241275161