PO-02-075 ASSOCIATIONS OF DEMOGRAPHICS AND COMORBIDITIES WITH LEFT ATRIAL SCAR BURDEN IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION UNDERGOING CATHETER ABLATION FROM THE REAL-AF REGISTRY

Previous research has shown that women are more likely to suffer significant complications of atrial fibrillation (AF). Scar burden at catheter ablation (CA) may indicate substrate and disease progression, but data are conflicting from small studies. Issues with voltage data include choice of mapping catheter, rhythm mapping was performed in, voltage cut-off used, and how truly representative low voltage is of scar. To examine the relationship of LA scar to demographics and patient comorbidities in a large registry of patients undergoing first-time radiofrequency AF ablation for persistent AF (PsAF). The Real-world Experience of Catheter Ablation for the Treatment of Symptomatic Paroxysmal AF and PsAF Using Novel Contact Force Technologies registry (Real-AF) is a prospective, observational, multicenter registry of over 5,000 patients undergoing CA with follow-up at 6 and 12 months. We evaluated 1,431 eligible patients among this cohort by using independent sample t and chi square testing to identify associations of demographics and comorbidities with degree of LA scar burden >= 5%, calculated from CARTO as total % LA area < 0.50mV bipolar. Mapping was performed using the Pentaray catheter and subgroup analysis was prespecified in those mapped during sinus. Mean age was greater among patients with LA scar burden ≥ 5% (66 vs 72 years, p<0.001). Women were more likely than men to have LA scar (55% vs 31%, p <0.001). Congestive heart failure (CHF) was associated with greater LA scar burden as well (46% vs 37%, p = <0.001). CHADSVASc was also greater in patients with LA scar (2.8 vs 3.6, p<0.001). Patients with scar were more likely to undergo substrate modification (SM) during ablation (85% vs 47%, p = <0.001). Among a subgroup of patients presenting in sinus (n=344), all above associations remained significant other than that of CHF and increased LA scar (46% vs 37%, p = 0.12). In early outcome data, LA scar was not predictive of increased AF recurrence 12 months following ablation compared to scar burden < 5% (24% vs 17%, p = 0.075). Increased LA scar burden was associated with female sex, greater age, CHADSVASc and CHF. As a categorical variable, there was no significant correlation between scar burden at time of first ablation and AF recurrence at 12 months, but further data is pending. This is the largest study to our knowledge to investigate correlation of patient characteristics and AF recurrence with degree of LA scarring in patients with persistent AF.