B-PO05-068 VALVULAR ATRIAL FIBRILLATION: TO ABLATE OR NOT

Abstract

The incidence rate and associated mortality of valvular atrial fibrillation (AF) continues to be significantly high. Drug therapy for such a malignant AF type offers minimal relief due to limited success rate and significant side effects. Catheter ablation for valvular AF is emerging as a reliable and successful treatment strategy. There is significant lack of data about its management and a systematic review with meta-analysis was carried out. PubMed, Cochrane Library and EMBASE databases were searched using PRISMA guidelines from 2004 to 2019 for studies evaluating the use of catheter ablation in valvular AF. A total of 96 studies were included through the database search, 52 studies were excluded as duplicate or irrelevant references, 18 studies were excluded by screening, eligibility excluded 2 articles, so the final number included in the quantitative synthesis was 24 studies. 4809 patients from 24 studies in the period from 2004 to 2019 were included. Systolic function increased after catheter ablation with an increase in ejection fraction (EF) from 43.3% to 50.3% (95% CI: 45.2 to 55.3, P < 0.0001). Catheter ablation was effective in restoring sinus rhythm in patients with valvular AF after the first procedure in 61.3%. With a second procedure done in 16 studies due to AF recurrence, the rate of success increased to 82.9%. AF catheter ablation is shown to have promising results in valvular heart diseases and heart failure patients. Given the current evidence, it is considered a safe procedure and can be effective with success rate up to 61.3 % for first procedure and 82.9% with second procedure.