Comparative analysis of long-term outcomes of thoracoscopic and ablation index-guided catheter ablation in patients with non-paroxysmal atrial fibrillation

Aim. To conduct a comparative assessment of the long-term results of thoracoscopic and catheter ablation using the ablation index in patients with non-paroxysmal atrial fibrillation (AF). Methods. A comparative analysis of the long-term results of catheter ablation using the ablation index - group № 1 (36 patients) and thoracoscopic ablation with the left atrial appendage exclusion - group № 2 (42 patients) was performed. Results. The effectiveness of catheter ablation was 57.14%, thoracoscopic ablation - 67.5% at 12-month followup (р=0,128). There were also no statistically significant differences in safety (p=0.55). Analyzing the structure of postprocedural atrial tachycardias in group №1 was demonstrated that AF recurrence was in 93.3%, in group №2 - in 50%. Atypical atrial flutter was documented in 6.6% of cases in group №1 and in 31.5% - in group №2. Typical atrial flutter was documented only in group №2 (18.75% (3)). However, AF recurrence was more common in the catheter ablation group after 6 months of follow-up (p=0.04). Conclusion. Catheter and thoracoscopic ablation are comparable in terms of overall efficacy and safety, however, thoracoscopic ablation provides greater freedom from AF in a 6 month.