Long term outcomes of percutaneous and thoracoscopic surgical ablation for atrial fibrillation in patients with continuous beat-to-beat monitoring

Introduction: Catheter ablation has been shown to be safe and effective in reducing atrial fibrillation (AF) burden and symptoms. However, there is limited long term data using continuous monitoring to assess the actual success of catheter ablation. This study assessed the long-term outcome of AF ablation in patients with implantable cardiac devices allowing beat-to-beat analysis of arrhythmia outcomes. Methods: 223 patients (mean age 75.9 ± 7.4, 50.9% men) who underwent catheter or thorascopic surgical ablation for symptomatic AF were studied. The techniques used were PVAC ablation (51.6%), cryoablation (16.1%), point by point (13.0%), nMARQ (12.1%) and surgical ablation (7.2%). All patients had a cardiac implantable device (109 pacemaker and 114 implantable loop recorder), and were followed up for a mean period of 735.2 ± 338.0 days, post ablation. Results: 146 (65.5%) patients had paroxysmal AF (PAF) and 77 (34.5%) patients had persistent AF. After first ablation there was a significant reduction in AF burden (relative risk 0.91, 95% CI 0.89 to 0.94; P =