Long-term follow-up of patients with pulmonary hypertension after catheter ablation of atrial fibrillation and atrial tachycardia.

Introduction: The previously published randomized trial comparing an extensive (targeting both clinical arrhythmia and bi-atrial arrhythmogenic substrate) and a limited (clinical arrhythmia only) approach to catheter ablation in patients with pulmonary hypertension did not demonstrate a significant difference in atrial tachyarrhythmia (ATA) recurrence during the one-year follow-up. This study presents the long-term results of these patients. Methods: Participants enrolled in the randomized trial (NCT04053361) were further followed and checked for ATA recurrence and all-cause mortality. Follow-up was primarily clinically driven, as the protocol for this secondary analysis was not fully prespecified. Results: A total of 74 patients [41 males, median age 71 years (IQR: 61; 75)] were randomized to the extended ( Conclusion: Extensive catheter ablation in patients with pulmonary hypertension did not reduce ATA recurrence during the routine follow-up of more than 40 months. Cavo-tricuspid isthmus ablation appears effective in preventing recurrence of typical atrial flutter, even in this high-risk population. Given the exploratory nature of these analyses, further research is needed.