Abstract
Background: CLBBB and AF are not uncommon coexisted. The impact
of CLBBB on long-term prognosis of catheter ablation of AF has not been
well determined.
Objectives: This study aims to explore the long-term outcomes
of patients with atrial fibrillation (AF) and complete left bundle
branch block (CLBBB) after catheter ablation.
Methods: Forty-two patients with CLBBB of the 11,752 patients
who underwent catheter ablation of AF from 2011 to 2020 were enrolled as
CLBBB group. After propensity score matching in a 1:4 ratio, 168 AF
patients without CLBBB were enrolled as Non-CLBBB group. The primary
endpoint was a composite of stroke, all-cause mortality, and
cardiovascular hospitalization. The secondary endpoint was AF recurrence
after single ablation.
Results: The incidence of the primary endpoint in the CLBBB
group was significantly higher than in the Non-CLBBB group (21.4% vs.
6.5%, HR 3.98, 95%CI 1.64-9.64, P = 0.002). The recurrence rates in
the CLBBB group and the Non-CLBBB group were 54.8% and 31.5% (HR 1.71,
95%CI 1.04-2.79, P = 0.034), respectively. Multivariate analysis showed
that CLBBB was an independent risk factor for both primary endpoint (HR
2.92, 95%CI 1.17-3.34, P = 0.022) and secondary endpoint (HR 2.19,
95%CI 1.09-4.40, P = 0.031) in patients with AF after catheter
ablation.
Conclusions: CLBBB significantly increased the risk of a
composite endpoint of stroke, all-cause mortality, and cardiovascular
hospitalization after catheter ablation in patients with AF. CLBBB also
independently predicted recurrence in these patients.
Key Words: atrial fibrillation, complete left bundle branch
block, catheter ablation