[Success rate of one-stop procedure for atrial fibrillation ablation and its impact on cardiac function: a propensity-matched study].

OBJECTIVE

To investigate the effect of the combination of atrial fibrillation (AF) ablation and left atrial appendage closure (LAAC) on cardiac function and the success rate of AF ablation.

METHODS

We retrospectively analyzed the data of 56 patients with AF undergoing a one-stop procedure for AF ablation and LAAC in our hospital between May, 2015 and May, 2019. Propensity score matching (PSM) at the ratio of 1:1 was used to select 56 control patients undergoing AF ablation at high risk of stroke, for matching with the hybrid procedure group. The perioperative complications, thromboembolic events, recurrence of atrial arrhythmia and cardiac function were compared between the groups.

RESULTS

The two groups of patients were comparable for age, gender, BMI, duration and type of AF, concomitant diseases, CHA2DS2-VASc and HAS-BLED scores ( > 0.05). The incidence of complications did not differ significantly between the hybrid procedure group and AF ablation group (17.9% 12.5%, =0.430). Compared with the control patients with AF ablation alone, the patients undergoing the hybrid procedure had a lowered incidence of thromboembolic events, but the difference was not statistically significant (1.8% 3.6%, =1.000). The hybrid procedure did not improve the success rate of AF ablation (OR: 1.338, 95%: 0.451-3.973, = 0.600) but significantly improved the cardiac function parameters including NT-pro BNP (945.3±1401.6 pg/mL 1520.7±2089.1 pg/mL, =0.010), LVEF[(60.8±7.0)% (58.6±7.8)%, =0.044], and left atrial diameter (43.9±7.5 mm 45.6±6.3 mm, =0.076); but the improvement of cardiac function was more obvious in the control patients undergoing AF ablation alone ( < 0.039).

CONCLUSIONS

The combination of AF ablation and LAAC is safe but does not improve the success rate of AF ablation. The one-stop procedure can improve cardiac function of the patients, but AF ablation alone can achieve better improvement of cardiac function.