Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-178 - Short And Long-term Clinical Outcomes Of Left Atrial Appendage Electrical Isolation In Patients With Non-paroxysmal Atrial Fibrillation: A Systematic Review And Meta-analysis (ID 1046)

Abstract

Background: The arrhythmogenic role of left atrial appendage electrical isolation (LAAEI) has been assessed for the treatment of non-paroxysmal atrial fibrillation. This technique has not been adopted for lack of long-term outcomes and studies with small sample size.
Objective: We sought to investigate the incremental benefit of LAAEI in all-atrial arrhythmia recurrence as well as incidence of total acute complications and embolic stroke.
Methods: A systematic review was performed for all clinical studies that assessed LAAEI for non-paroxysmal AF.
Results: The benefit of LAAEI was analyzed from nine studies that enrolled a total of 2336 patients. All studies included patients with non-paroxysmal AF. The overall freedom from all-atrial arrhythmia recurrence off antiarrhythmic medication at a mean follow-up of 23.72 ±18 months in patients who underwent LAAEI vs. standard ablation without LAAEI alone was 69.3% vs. 46.4%, respectively [46% relative reduction and 22.9% absolute reduction; risk ratio (RR) 0.54, 95% CI (95% CI) 0.42-0.69; P<00001]. The rate of ischemic stroke or transient ischemic attack (TIA) was not significantly different between the LAAEI and standard ablation groups (3% and 1.6%, respectively; RR 1.76; 95% CI 0.61-5.04; P=0.29). Furthermore, there was no significant difference in the acute complication rates between both groups (LAAEI 4%, standard ablation 3%; RR 1.29; 95% CI 0.83-2.02; P=0.26).
Conclusion: Left atrial appendage electrical isolation seems to have an incremental benefit in achieving freedom from all-atrial arrhythmias in patients with non-paroxysmal AF. In addition, this benefit is not associated with an increased risk of thromboembolic events.
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