Hybrid m-BOX and driver ablation reduced the 12-month recurrence of atrial arrhythmias by 51% compared to m-BOX ablation alone in patients with non-paroxysmal atrial fibrillation (HR 0.49).
Cohort (n=261)
No
Does hybrid m-BOX and driver ablation reduce arrhythmia recurrence in patients with non-paroxysmal atrial fibrillation compared to m-BOX ablation alone?
Hybrid modified BOX and driver ablation significantly reduces 12-month arrhythmia recurrence compared to modified BOX ablation alone in patients with non-paroxysmal atrial fibrillation.
Estimación del efecto: HR 0.49 (95% CI 0.30-0.80)
Tasa de eventos absoluta: 21.8% vs 34.8%
valor p: p=0.005
BACKGROUND: For patients with non-paroxysmal atrial fibrillation (AF), the necessity of linear ablation remains uncertain, and the benefits of posterior wall BOX isolation continue to be controversial. Recent evidence has demonstrated positive effects of driver ablation. Therefore, we designed a novel strategy termed modified posterior wall BOX isolation (m-BOX, roof line and inferior line along coronary sinus projection to connect pulmonary veins), and hybrid m-BOX and driver ablation (HOT). OBJECTIVE: To evaluate the effectiveness of high-density mapping-guided m-BOX or HOT in patients with non-paroxysmal AF. METHODS: The study is retrospective, non-randomized, and single center. A total of 148 patients who underwent HOT and 113 patients who underwent m-BOX ablation were included in the study. All patients were scheduled for a 12-month follow-up after the procedure. Recurrence was defined as AF, atrial tachycardia, or atrial flutter lasting ≥ 30 s after the blanking period. RESULTS: The HOT group exhibited a statistically lower 12-month recurrence rate compared to the m-BOX group (21.8% vs. 34.8%, HR 0.49, 95% CI 0.30-0.80; P = 0.005). Among patients in the HOT group, those in whom sinus rhythm (SR) was restored by ablation demonstrated a numerically lower recurrence rate compared to those without SR restoration (16.7% vs. 26.7%, HR 95% CI:0.60 0.28-1.28; P = 0.37). Irrespective of the ablation strategy, restoration of SR by ablation was associated with a lower recurrence rate (16.2% vs. 34.4%, HR 95% CI:0.43 0.24-0.76; P = 0.01). CONCLUSION: Compared to those receiving m-BOX ablation, patients who underwent HOT ablation were associated with lower recurrence.
Xiong et al. (Mon,) conducted a cohort in Non-paroxysmal atrial fibrillation (n=261). Hybrid m-BOX and driver ablation (HOT) vs. Modified posterior wall BOX isolation (m-BOX) was evaluated on Recurrence of atrial fibrillation, atrial tachycardia, or atrial flutter lasting ≥30 seconds after the 3-month blanking period (HR 0.49, 95% CI 0.30-0.80, p=0.005). Hybrid m-BOX and driver ablation reduced the 12-month recurrence of atrial arrhythmias by 51% compared to m-BOX ablation alone in patients with non-paroxysmal atrial fibrillation (HR 0.49).