Long-term Outcomes of Left Atrial Appendage Electrical Isolation in Patients with Non-Paroxysmal Atrial Fibrillation: A Propensity Score-Matched Analysis

BACKGROUND–Left atrial appendage electrical isolation (LAAEI) has been proposed for the treatment of non-paroxysmal atrial fibrillation (AF). The long-term clinical outcomes and safety of this approach remain unclear. The objective of our study was to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation (CA) for non-paroxysmal AF. METHODS–Propensity score-matched analysis was performed using a prospective registry database from 2010-2014. All patients in the LAAEI group were matched based on baseline characteristics, echocardiographic parameters, and procedural ablation techniques. RESULTS–We identified 1842 patients who underwent CA for non-paroxysmal AF. Propensity score matching yielded 1092 patients, 546 patients with LAAEI and 546 patients without LAAEI. At 5-year follow-up, overall freedom from all-atrial arrhythmia recurrence, off-anti-arrhythmic drugs, in patients who underwent LAAEI was 68.9% vs. 50.2% in those who underwent standard ablation alone (p