3.4 | Follow-up and redo procedures
Follow-up was available in 18 patients (95%) a median of 3.5 months (IQR 3.0-11.0) after VOM-EI. One patient was lost of follow-up. Ten patients (56%) had recurrence of arrhythmia. Arrhythmia recurred as atrial fibrillation in six patients (60%) and as atrial flutter in four (40%). A repeat ablation procedure was performed in five patients (50%). Among these, a peri-mitral flutter was diagnosed in three (60%). The gaps in the mitral isthmus line located to the annular side in two patients and on both the annular and pulmonary venous side in the third patient. Re-ablation was performed endocardially in all three patients and within the CS in two patients, with induction of complete mitral isthmus block in all patients.
In two patients (40%), the mitral isthmus was still blocked during the redo procedure.
The median low-voltage area in the lateral left atrium during the redo procedure was smaller compared to the low-voltage area at the end of the index procedure (13.2 cm2 [IQR 8.2-15.0] versus 10.5 cm2 [IQR 6.5-14.9], respectively; P = 0.345; Figure 8).