Early recurrence of atrial tachyarrhythmia indicates pulmonary vein reconduction independent of blanking period duration in the RACE-AF trial
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Early recurrence of atrial tachyarrhythmia indicates pulmonary vein reconduction independent of blanking period duration in the RACE-AF trial. / Sørensen, Samuel K.; Johannessen, Arne; Worck, René; Hansen, Morten L.; Ruwald, Martin H.; Hansen, Jim.
I: Journal of Cardiovascular Electrophysiology, Bind 34, Nr. 12, 2023, s. 2434-2442.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Early recurrence of atrial tachyarrhythmia indicates pulmonary vein reconduction independent of blanking period duration in the RACE-AF trial
AU - Sørensen, Samuel K.
AU - Johannessen, Arne
AU - Worck, René
AU - Hansen, Morten L.
AU - Ruwald, Martin H.
AU - Hansen, Jim
N1 - Publisher Copyright: © 2023 Wiley Periodicals LLC.
PY - 2023
Y1 - 2023
N2 - Introduction: Atrial tachyarrhythmia recurrence during the blanking period (early ATA) after pulmonary vein isolation (PVI) is associated with an increased risk of later recurrence, but its relationship with pulmonary vein reconduction (PVR) is poorly understood. The objective of the present study was to evaluate the relationship between early ATA and PVR. Second, to provide data on the optimal blanking period by (a) evaluating how the predictive values of ATA for PVR are affected by blanking period duration, and (b) assessing the temporal development in atrial fibrillation (AF) burden. Methods: In this RACE-AF substudy, 91 patients with paroxysmal AF undergoing PVI randomized to radiofrequency or cryoballoon ablation were included. All patients received an implantable cardiac monitor and underwent a protocol-mandated repeat procedure after 4–6 months for assessment of PVR. ATA ≥ 30 s. ≤ 90 days after PVI constituted early ATA. Results: PVR was found in 37/54 (69%) patients with early ATA and in 11/37 (30%) patients without (p <.001). The positive predictive value of ATA for PVR was independent of blanking period duration (range 0–90 days). In both patients with and without PVR, AF burden was higher in the first month after PVI, but AF burden from the second month was similar to AF burden after the conventional blanking period. Conclusion: Early ATA indicates PVR, and the positive predictive value is independent of the blanking period duration. Altogether, the results of this study support substantially shortening the blanking period after PVI for paroxysmal AF.
AB - Introduction: Atrial tachyarrhythmia recurrence during the blanking period (early ATA) after pulmonary vein isolation (PVI) is associated with an increased risk of later recurrence, but its relationship with pulmonary vein reconduction (PVR) is poorly understood. The objective of the present study was to evaluate the relationship between early ATA and PVR. Second, to provide data on the optimal blanking period by (a) evaluating how the predictive values of ATA for PVR are affected by blanking period duration, and (b) assessing the temporal development in atrial fibrillation (AF) burden. Methods: In this RACE-AF substudy, 91 patients with paroxysmal AF undergoing PVI randomized to radiofrequency or cryoballoon ablation were included. All patients received an implantable cardiac monitor and underwent a protocol-mandated repeat procedure after 4–6 months for assessment of PVR. ATA ≥ 30 s. ≤ 90 days after PVI constituted early ATA. Results: PVR was found in 37/54 (69%) patients with early ATA and in 11/37 (30%) patients without (p <.001). The positive predictive value of ATA for PVR was independent of blanking period duration (range 0–90 days). In both patients with and without PVR, AF burden was higher in the first month after PVI, but AF burden from the second month was similar to AF burden after the conventional blanking period. Conclusion: Early ATA indicates PVR, and the positive predictive value is independent of the blanking period duration. Altogether, the results of this study support substantially shortening the blanking period after PVI for paroxysmal AF.
KW - blanking period
KW - early recurrence
KW - implantable cardiac monitor
KW - protocol-mandated repeat procedure
KW - pulmonary vein isolation
U2 - 10.1111/jce.16098
DO - 10.1111/jce.16098
M3 - Journal article
C2 - 37814483
AN - SCOPUS:85173789018
VL - 34
SP - 2434
EP - 2442
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 12
ER -
ID: 389363324