Key result
Radiofrequency, cryoballoon, and thoracoscopic maze show no difference in 12-month arrhythmia recurrence for persistent AF.
Why the study?
Clinical outcomes of pulmonary vein antrum isolation remain unsatisfactory in patients with persistent AF and a large left atrium.
Does radiofrequency ablation, cryoballoon ablation, or thoracoscopic maze prevent recurrence of atrial arrhythmia in patients with persistent AF and a large LA?
Cohort (n=89)
No
Does radiofrequency ablation, cryoballoon ablation, or thoracoscopic maze prevent recurrence of atrial arrhythmia in patients with persistent AF and a large LA?
In patients with persistent AF and a large LA, RFCA, CBA, and thoracoscopic maze showed no significant difference in 12-month atrial arrhythmia recurrence.
Background: Pulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation, but the clinical outcomes of PVAI are unsatisfactory in patients with persistent AF and a large left atrium (LA). Objectives: We investigated the clinical outcomes following radiofrequency ablation (RFCA), cryoballoon ablation (CBA), and thoracoscopic maze in patients with persistent AF and a large LA. Methods: We included patients with consecutive persistent AF who had a large LA (LA diameter >50 mm) and underwent RFCA, CBA, or thoracoscopic maze surgery. In the RFCA group, additional linear ablation was performed at the physician's discretion. The endpoint was 12 months without recurrence of an atrial arrhythmia, including AF, atrial flutter, and atrial tachycardia, following a 90-day blanking period. Early recurrence during the blanking period was a significant predictor of late recurrence for RFCA and CBA, but not for the thoracoscopic maze. Conclusion: In persistent AF patients with a large LA, we did not find a prognostic difference RFCA, CBA, or a thoracoscopic maze procedure in recurrence of atrial arrhythmia. Early recurrence predicted late recurrence in catheter ablation, but not in thoracoscopic maze.
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Park et al. (2022) conducted a cohort in Persistent atrial fibrillation with large left atrium (n=89). Radiofrequency catheter ablation (RFCA) or Cryoballoon ablation (CBA) vs. Thoracoscopic maze procedure was evaluated on Late recurrence of atrial arrhythmia during the 12-month follow-up (following a 90-day blanking period) (p=>0.05). In patients with persistent atrial fibrillation and a large left atrium, there was no significant difference in 12-month atrial arrhythmia recurrence between radiofrequency ablation (50.0%), cryoballoon ablation (52.6%), and thoracoscopic maze (63.2%).
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