Journal article
Predictive value of premature atrial complex characteristics in pulmonary vein isolation for patients with paroxysmal atria fibrillation
Archives of cardiovascular diseases, Vol.114(2), pp.122-131
02/01/2021
DOI: 10.1016/j.acvd.2020.09.001
PMID: 33153949
Abstract
Background. - Premature atrial complexes from pulmonary veins are the main triggers for atrial complexes; fibrillation in the early stages. Thus, pulmonary vein isolation is the cornerstone of catheter ablation for paroxysmal atrial fibrillation. However, the success rate remains perfectible.
Aim. - To assess whether premature atrial complex characteristics before catheter ablation can predict pulmonary vein isolation success in paroxysmal atrial fibrillation.
Methods. - We investigated consecutive patients who underwent catheter ablation for paroxysmal atrial fibrillation from January 2013 to April 2017 in two French centres. Patients were included if they were treated with pulmonary vein isolation alone, and had 24-hour Hotter electrocardiogram data before catheter ablation available and a follow-up of >= 6 months. Catheter ablation success was defined as freedom from any sustained atrial arrhythmia recurrence after a 3-month blanking period following catheter ablation.
Results. - One hundred and three patients were included; all had an acute successful pulmonary vein isolation procedure, and 34 (33%) had atrial arrhythmia recurrences during a mean follow-up of 30 +/- 15 months (group 1). Patients in group 1 presented a longer history of atrial fibrillation (71.9 +/- 65.8 vs. 42.9 +/- 48.4 months; P=0.008) compared with those who were "free from arrhythmia" (group 2). Importantly, the daily number of premature atrial complexes before catheter ablation was significantly lower in group 1 (498 +/- 1413 vs. 1493 +/- 3366 in group 2; P=0.028). A daily premature atrial complex cut-off number of < 670 predicted recurrences after pulmonary vein isolation (41.1% vs. 13.3%; sensitivity 88.2%; specificity 37.7%; area under the curve 0.635; P=0.017), and was the only independent predictive criterion in the multivariable analysis (4-fold increased risk).
Conclusion. - Preprocedural premature atrial complex analysis on 24-hour Hotter electrocardiogram in paroxysmal atrial fibrillation may improve patient selection for pulmonary vein isolation. (C) 2020 Elsevier Masson SAS. All rights reserved.
Details
- Title: Subtitle
- Predictive value of premature atrial complex characteristics in pulmonary vein isolation for patients with paroxysmal atria fibrillation
- Creators
- David Hamon - Hôpitaux Universitaires Henri MondorBaptiste Courty - Hôpitaux Universitaires Henri-MondorAntoine Leenhardt - Assistance Publique – Hôpitaux de ParisPascal Lim - Hôpitaux Universitaires Henri-MondorNathalie Elbaz - Hôpitaux Universitaires Henri-MondorSegolene Rouffiac - Hôpitaux Universitaires Henri-MondorVarlet Emilie - Assistance Publique – Hôpitaux de ParisVincent Algalarrondo - Assistance Publique – Hôpitaux de ParisAnne Messali - Hôpital Bichat-Claude-BernardEtienne Audureau - Assistance Publique – Hôpitaux de ParisFabrice Extramiana - Assistance Publique – Hôpitaux de ParisNicolas Lellouche - Hôpitaux Universitaires Henri-Mondor
- Resource Type
- Journal article
- Publication Details
- Archives of cardiovascular diseases, Vol.114(2), pp.122-131
- DOI
- 10.1016/j.acvd.2020.09.001
- PMID
- 33153949
- NLM abbreviation
- Arch Cardiovasc Dis
- ISSN
- 1875-2136
- eISSN
- 1875-2128
- Publisher
- Elsevier
- Number of pages
- 10
- Language
- English
- Date published
- 02/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691517902771
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