Catheter ablation of atrial fibrillation in patients with left bundle branch block

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Left bundle branch block (LBBB) and atrial fibrillation (AF) frequently coexist.
• The effect of LBBB on AF catheter ablation outcomes is not well understood.

Purpose of the Study:

• To investigate the long-term results of catheter ablation for AF in patients with LBBB.

Main Methods:

• Retrospective analysis of 42 patients with LBBB and 168 matched controls without LBBB who underwent AF ablation (2011-2020).
• Propensity score matching was used to create comparable groups.
• Comparison of late recurrence rates and a composite endpoint (stroke, mortality, cardiovascular hospitalization).

Main Results:

• Late recurrence was significantly higher in the LBBB group (54.8%) versus the non-LBBB group (31.5%), p=0.034.
• LBBB was an independent risk factor for late recurrence (HR 2.19, p=0.031).
• The composite endpoint incidence was higher in the LBBB group (21.4%) compared to the non-LBBB group (6.5%), p=0.002.

Conclusions:

• Left bundle branch block is associated with increased risk of late recurrence after AF catheter ablation.
• Patients with LBBB undergoing AF ablation face a higher risk of adverse composite outcomes.