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Evaluating the Effectiveness of Combined Left Atrial Posterior Wall Linear Ablation and Pulmonary Vein Isolation in
Weiwei Zhang1, Tianhua Xie2, Mingjie Xie3
1Department of Cardiac Surgery, First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Erqi District, Zhengzhou, 450052, Henan, China. zwwxinwaike@163.com.
Purpose:
This study aimed to evaluate whether combining left atrial posterior wall linear ablation with PVI (LAPVI) improves long-term outcomes in patients with persistent AF.
Methods:
In a randomized controlled trial, 228 patients with persistent AF underwent PVI and were randomly assigned to either receive additional LAPVI or not. Procedures used a standardized protocol under general anesthesia. Outcomes, including sinus rhythm maintenance and recurrence rates of AF, were assessed at 6 months, 1 year, and 2 years post-procedure. Statistical analysis was performed using the chi-square test for categorical variables and t-tests for continuous variables.
Results:
At 2 years, 74.77% of the LAPVI group maintained sinus rhythm compared to 54.7% in the PVI group (P = 0.002). Recurrence rates of paroxysmal and persistent AF were significantly lower in the LAPVI group at 11.71% and 9.01%, respectively, versus 24.79% and 20.51% in the PVI group (P < 0.05). Antiarrhythmic drug use was significantly reduced in the LAPVI group at each follow-up interval (P < 0.05).
Conclusion:
LAPVI significantly enhances long-term rhythm control and reduces dependence on antiarrhythmic drugs compared to PVI alone in patients with persistent AF.
