Early markers of atrial fibrillation recurrence after pulmonary vein isolation. Issue 2 (7th February 2020)

• Record Type: Journal Article
• Authors: Lanters, Eva A. H.; Teuwen, Christophe P.; Hokken, Thijmen; Rohde, Sofie; Haitsma, David B.; Zijlstra, Felix; Jordaens, Luc J. L. M.; de Groot, Natasja M. S.
• Is Part Of: Journal of arrhythmia. Volume 36:Issue 2(2020)
• Page Start: 304
• Page End: 310
• Publication Date: 2020-02-07
• Subjects: atrial extrasystolic beat -- atrial fibrillation -- blanking period -- pulmonary vein isolation -- recurrence; Arrhythmia -- Periodicals; Cardiac pacing -- Periodicals; Arrhythmias, Cardiac; Arrhythmia; Cardiac pacing; Periodicals; Electronic journals; Periodicals; 616.128
• DOI: 10.1002/joa3.12307
• Languages: English
• ISSNs: 1880-4276

Abstract

Abstract: Background: Postprocedural atrial extrasystole (AES) frequency predicts atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) in patients with paroxysmal AF. However, the predictive value of preprocedural AES frequency is unknown. We investigate whether preprocedural AES frequency is a feasible marker to predict (timing of) AF recurrence after PVI. Methods: Patients (N = 684) with paroxysmal or persistent AF undergoing first‐time PVI were evaluated for (a) the frequency of AES/day on Holter recordings without AF prior to PVI, (b) AF episodes during the 90 days blanking period, and (c) AF recurrences afterward. The correlation between AES/day and both development and timing of AF recurrences was tested. Results: Preprocedural AES/day was similar in patients with paroxysmal (66 [20‐295] AES/day) and persistent AF (115 [12‐248] AES/day, P = .915). During the blanking period, 302 (44.2%) patients showed AF episodes. AF recurred in 379 (55.4%) patients at 203 (105‐400) days after PVI. AF recurred more frequently in patients with persistent (N = 104 [69.3%]) than in patients with paroxysmal AF (N = 275 [51.5%], P < .001). Frequency of AES prior to PVI was not correlated with development ( P = .203) or timing ( P = .478) of AF recurrences. AF recurrences occurred both more frequently ( P < .001) and earlier ( P < .000) in patients with AF during the blanking period. Conclusion: AES/day prior to PVI is not correlated with (timing of) AF during the blanking period or AF recurrences, and is therefore not a feasible marker for AF recurrences in patients with PAF. AF during the blanking period is correlated with AF recurrence. Abstract : Atrial extrasystole (AES)/day prior to pulmonary vein isolation (PVI) is not correlated with (timing of) atrial fibrillation (AF) during the blanking period or AF recurrences and is therefore not a feasible marker for AF recurrences in patients with paroxysmal AF (PAF). As an incidental finding, AF during the blanking period was correlated with AF recurrence.