4.5 Long term outcome
Our study showed that patients with AT had a better prognosis in
maintaining SR than those with AF. Evidently, it should not be
overlooked that patients with AT had a much higher rate of previous LA
ablation than patients with AF. Apparently, during the AT ablation,
apart from the MI, additional ablation was carried out to treat other
ATs or to re-isolate the PVs. Probably, when ΑΤ becomes a clinical
arrhythmia after AF ablation, a less complex substrate is created, which
if mapped in detail, can be ablated with great success and favorable
long-term results [32].
In the redo cases we found the pacing-proven maintenance of MI line at a
rate of 86%. On the other hand, the maintenance rate of PVI per patient
with at least one PV reconnected and per PV was 27% and 55%,
respectively, after 1.1 previous AF ablation procedures. Our findings
are consistent with the study by Mujiovic et al. [33] in which the
invasive re-evaluation, 3 months after the index procedure, showed
numerically higher maintenance rate in linear lesions than in PVI. We do
not know why this happens. It is possible that the greater persistence
on a limited surface and the definite procedural endpoint in MI ablation
lead to more transmural lesions.