Evaluating the Effectiveness of Combined Left Atrial Posterior Wall Linear Ablation and Pulmonary Vein Isolation in Reducing Long-Term Recurrence Rates After Surgery in Patients with Persistent Atrial Fibrillation: A Randomized Controlled Trial.

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.