Long-term results of the preventive block of the cavatricuspidal itsthus in interventional treatment of atrial fibrillation

Safonov Nikita Vladimirovich, Vladislav Yurievich Baranovich, Faibushevich Alexander Georgievich

The purpose of this study: To determine the long-term results of preventive block in the cavatricuspid isthmus during isolation of the pulmonary vein orifices. The study was conducted from 2018 to 2020. Inclusion criteria: paroxysmal AF, absence of atrial fibrillation. Presence of risk factors for TP. Exclusion criteria: typical or atypical LT. The study included 42 patients. The first group performed only isolation of the pulmonary vein orifices. The second group is the isolation of the orifices of the pulmonary veins simultaneously with the ablation of the CTP. The primary endpoint is the absence of AF and AT during the blind period. The secondary endpoint was the absence of AF paroxysms documented by ECG or HM-ECG (duration 60 s) after the blind period (3 months), the occurrence of typical atrial flutter atrial flutter. Pulmonary vein isolation criteria were obtained in all patients. The efficiency of CTP ablation was 100%. During the blind period (3 months), AF paroxysms were recorded in 5 patients (23.81%) patients in the first group and in 4 patients (19.05%) in the second group. The efficiency of the operation within one year (efficiency in atrial fibrillation) in the first group was (76.19%), in the second group (71.43%). No recurrence of typical atrial flutter was observed in the second group. In the first group, there were 3 (14.29%) cases of TP. Below is table No. 4 for the risk factors of recurrent patients (TP) from the first group. Efficiency for atrial fibrillation in the first group within two years was 66.67% (14 patients), in the second group 61.9% (13 patients). There were no cases of TP in the second group after 2 years of follow-up. In the first group, 4 cases of TP were identified within two years (19.05%). It is possible to perform preventive ablation in patients with risk factors for AT, especially in patients with multiple risk factors for AT. Preventive ablation of CTP insignificantly increases the operation time and does not increase the number of intraoperative complications. Preventive ablation of CTP insignificantly lengthens the operation time, does not affect the occurrence of complications, and can reduce the number of subsequent hospitalizations and reoperations.

Keywords:atrial fibrillation, atrial flutter, risk factors, radiofrequency ablation