Patients with long-standing Atrial Fibrillation are often the hardest to make A-Fib free. Because of having been in A-Fib for so long, they may have developed many A-Fib producing spots in their heart besides in the Pulmonary Veins (PVs).
Patients with long-standing Atrial Fibrillation are often the hardest to make A-Fib free
To make them A-Fib free, the electrophysiologist (EP) must ablate (isolate) not only the Pulmonary Veins, but also many non-PV triggers. Isolating the Left Atrial Appendage (LAA) significantly increased the success of catheter ablation in long-standing persistent A-Fib patients.
BELIEF Trial—LAA Isolation 76% Success Rate
In a randomized study (BELIEF trial), 173 patients with persistent A-Fib either received standard ablation plus LAA isolation or standard ablation alone. (If patients continued to have A-Fib, they could have a repeat ablation which included LAA isolation.)
At 2 years, 76% of patients who had received standard ablation plus LAA isolation were free of arrhythmia vs 56% of patients who had received only a standard ablation.
Dr. Luigi Di Biase, who presented the findings at the European Society of Cardiology 2015 Congress, stated “We do believe (LAA isolation) should be the standard of care in patients with longstanding AF.”
Isolating the LAA improved long-term freedom from persistent A-Fib.
But 52% Had Impaired LAA Function
Isolating the LAA can cause problems. If many burns have to be made at the LAA to achieve isolation, they may reduce the ability of the LAA to contract properly. … Continue reading this report…->