IMPACT OF RIGHT ATRIAL LINES ON EIGHT-YEAR RHYTHM OUTCOME FOLLOWING BIPOLAR RADIOFREQUENCY MAZE

Background. Eight-year clinical results of surgical bipolar radiofrequency (BRF) atrial fibrillation (AF) ablation were analyzed. Methods. One-hundred-twenty-two patients undergoing BRF without (n=57) or with (n=65) concomitant right atrial (RA) ablation were assessed for sinus rhythm recovery at a median follow up of 38.8 months (27.0-86.5). A competing risk model was used to appropriately estimate the incidence of AF and surgical techniques were analysed for their association with AF recurrence employing a competing risk regression corrected for atrial dimensions using sub-hazard ratios (SHRs) as measure of association. Results. The percentage of patients in normal sinus rhythm and offantiarrhythmic drugs were 75.4% (n=43) in the RA ablation and 56.9% (n=37) in the no-RA ablation Groups (p<0.001). Eight-year cumulative incidence of AF recurrence was significantly lower in the Group receiving RA lines (Figure 1). The absence of RA ablation (SHR 3.84 95% CI 1.27-6.48, p=0.001) was the only surgical factor independently associated with AF recurrence at follow up. Roof (SHR 1.54 0.61-3.84, p=0.233), inferior (SHR 1.39 0.42-3.39, p=0.30) left appendage-to pulmonary veins (SHR 1.56 0.87-4.06, p=0.112) and mitral isthmus (SHR 1.67 0.94-4.23, p=0.151) lines were not significant. Conclusions. Our experience suggests that a right-sided ablation should be routinely added to BRF left atrial ablation for atrial fibrillation. Further studies are necessary to confirm our results.