023 * COMPARISON OF LEFT AND BIATRIAL ABLATION TECHNIQUES IN NON-MITRAL PATIENTS WITH ATRIAL FIBRILLATION: A RANDOMIZED STUDY

Abstract

Objectives: Outcomes of different lesion sets during concomitant ablation in non-mitral patients with atrial fibrillation (AF) remain unknown. Methods: From 2009 to 2012, 72 patients with AF underwent non-mitral procedures (aortic valve or aortic root procedure, coronary artery bypass grafting) and concomitant bipolar radiofrequency ablation. There were 30 (47.2%) patients with persistent and 42 (52.8%) with long-standing persistent AF. The mean age was 61.3 +/- 9.6 years. Patients were randomized into two arms: complete left atrial ablation procedure (n = 37) (LA group) and biatrial maze IV procedure (n = 34) (BM group). At the end of the operation, an implantable loop recorder for continuous monitoring was implanted. Follow-up data were analysed for 12 months. Results: Hospital mortality was one (2.7%) patient in the LA group (P = 0.367). No procedure-related complications occurred with regard to either ablation or the monitoring device. There was no difference in the incidence of early AF paroxysms between the two groups (42.9% vs 38.0%, P = 0.651). Pacemaker implantation before discharge due to sinus node dysfunction was required in one patient in each group: 2.7% (LM group) and 2.9% (BM group) (P = 0.531). Calculated mean AF burden during the follow-up period (based on continuous monitoring) was higher in the LA group compared with the BM group, average 19.6 +/- 6.7% and 8.8 +/- 1.9% respectively (P = 0.013). Conclusions: According to continuous monitoring data, freedom from AF was significantly higher after biatrial maze in comparison with left atrial ablation procedure in non-mitral patients with AF.