Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation
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Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation. / Alhede, Christina; Johannessen, Arne; Dixen, Ulrik; Jensen, Jan S.; Raatikainen, Pekka; Hindricks, Gerhard; Walfridsson, Håkan; Kongstad, Ole; Pehrson, Steen; Englund, Anders; Hartikainen, Juha; Hansen, Peter S.; Nielsen, Jens C.; Jons, Christian.
I: Europace, Bind 20, Nr. 1, 2018, s. 50-57.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation
AU - Alhede, Christina
AU - Johannessen, Arne
AU - Dixen, Ulrik
AU - Jensen, Jan S.
AU - Raatikainen, Pekka
AU - Hindricks, Gerhard
AU - Walfridsson, Håkan
AU - Kongstad, Ole
AU - Pehrson, Steen
AU - Englund, Anders
AU - Hartikainen, Juha
AU - Hansen, Peter S.
AU - Nielsen, Jens C.
AU - Jons, Christian
PY - 2018
Y1 - 2018
N2 - 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. 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≥783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF≥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 (≥783 SVEC: HR 4.6 [1.9-11.5], P<0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence<90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC≥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. 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.
AB - 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. 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≥783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF≥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 (≥783 SVEC: HR 4.6 [1.9-11.5], P<0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence<90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC≥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. 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.
KW - Arrhythmia
KW - Atrial fibrillation
KW - Atrial premature complexes
KW - Recurrence
KW - Treatment
U2 - 10.1093/europace/euw329
DO - 10.1093/europace/euw329
M3 - Journal article
C2 - 28011799
AN - SCOPUS:85040770698
VL - 20
SP - 50
EP - 57
JO - Europace
JF - Europace
SN - 1099-5129
IS - 1
ER -
ID: 217697709