Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillationShow others and affiliations
2018 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 20, no 1, p. 50-57Article in journal (Refereed) Published
Abstract [en]
Aims Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. Methods and results A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and amp;gt;= 783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF amp;gt;= 1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (amp;gt;= 783 SVEC: HR 4.6 [1.9-11.5], P amp;lt; 0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence amp;lt; 90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC amp;gt;= 213: HR 3.0 [1.3-6.7], P = 0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period. Conclusion Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.
Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2018. Vol. 20, no 1, p. 50-57
Keywords [en]
Arrhythmia; Atrial fibrillation; Treatment; Recurrence; Atrial premature complexes
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-144568DOI: 10.1093/europace/euw329ISI: 000419659300009PubMedID: 28011799OAI: oai:DiVA.org:liu-144568DiVA, id: diva2:1178279
Note
Funding Agencies|Gerda and Aage Haenschs Foundation; Hans og Nora Buchards Foundation; Jens Anker Andersen Foundation; Classenske Fideicommi Foundation
2018-01-292018-01-292018-01-29