Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-161 - Endocardial Left Atrial Appendage Isolation: Impact Of Ablation Technique On The Risk Of In-situ Thrombus Formation, Systemic Thromboembolization And Hemodynamics (ID 119)


Background: Left atrial appendage (LAA) js an important source of arrhythmia in patients with atrial fibrillation (AF). Often endocardial isolation of the LAA is performed with variable success and risk of thrombus and embolization. There seems to be significant variation in the technique used and its impact on outcomes is poorly understood
Objective: We studied the differences in arrhythmia freedom, insitu thrombus, thromboembolization and hemodynamic effects between a wide (group1) versus a close ostial (group-2) LAA isolation.
Methods: We retrospectively compared pts undergoing AF ablation with LAA isolation.Group1 includes a wide antral PV isolation/Roofline/inferior line/MI line and an anterior line from RSPV to MV. While LAA isolation was limited close to the ostium in group2.Standard statistical methods were used.
Results: 224 pts age and gender matched (group1=112 and group2=112) enrolled. Mean age 70 yrs with 78% females. The details of demographics and outcomes are outlined in the table. Freedom from AF and AT at 12 months was significantly better with group2. The overall LAA emptying velocities at 6 months was significantly lower in group1. Risk of thrombus formation while on OAC and STE was also significantly higher with group1.
Conclusion: Close ostial isolation of LAA has a lower risk of insitu thrombosis, systemic thromboembolism, recurrent AT/AF, SBP and stiff LA syndrome than wider LAA isolation