Literature DB >> 18263865

What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring.

Daniel Steven1, Thomas Rostock, Boris Lutomsky, Hanno Klemm, Helge Servatius, Imke Drewitz, Kai Friedrichs, Rodolfo Ventura, Thomas Meinertz, Stephan Willems.   

Abstract

AIMS: Rhythm follow-up after catheter ablation of atrial fibrillation (AF ablation) is mainly based on Holter electrocardiogramm (ECG), tele-ECG or on patients symptoms. However, studies using 7-day Holter or tele-ECG follow-up revealed a significant number of asymptomatic recurrences. Thus, the aim of this study was to analyse continuous atrial recordings in pacemaker patients with an incorporated Holter function before and after AF ablation in order to determine all AF recurrences and thereby the 'real' success rates. METHODS AND
RESULTS: The study comprised 37 patients (64.6 +/- 10 years) with prior pacemaker/implantable cardioverter defibrillator (ICD) implantation including an atrial Holter function referred for AF ablation. Holter data were obtained and correlated to patients' symptoms before and every 3-month after AF ablation. AF recurrence was defined as an atrial high frequency episode of less than 330 ms (180 b.p.m.) lasting longer than 30 s. The ablation procedure consisted of pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF, n = 20) and additional substrate modification aiming arrhythmia termination in patients with persistent or inducible AF after PVI as well as in patients with a history of long-lasting persistent AF (PersAF, n = 17). The mean atrial Holter monitoring period was 7.4 +/- 3.3 months before and 13.5 +/- 4.2 months after ablation with an overall AF burden of 33.7% prior to ablation. During follow-up, AF burden decreased from 17.3-0.65% (P = 0.001) in PAF patients and from 57.4 to 13.9% (P = 0.024) in patients with PersAF. Complete AF freedom was observed in 85% (17 patients) of PAF patients and 59% (10 patients) in patients with PersAF. The absence of symptoms correlated well with documented freedom of AF.
CONCLUSION: In the present study we could show, that freedom from AF can be achieved by catheter ablation in a high percentage of patients even with PersAF. Continuous atrial monitoring reveals AF ablation success rates comparable with those assessed by clinical evaluation. Symptomatic freedom of AF correlated well with the actual freedom of AF at least in this highly symptomatic patient cohort.

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Mesh:

Year:  2008        PMID: 18263865     DOI: 10.1093/eurheartj/ehn024

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


  20 in total

1.  Clinical experience with routine use of a single combined mapping and ablation catheter for isolation of pulmonary veins in patients with paroxysmal atrial fibrillation.

Authors:  Clemens Steinwender; Simon Hönig; Franz Leisch; Robert Hofmann
Journal:  Wien Klin Wochenschr       Date:  2010-03       Impact factor: 1.704

2.  Pulmonary vein isolation with Mesh Ablator versus cryoballoon catheters: 6-month outcomes.

Authors:  Robert Hofmann; Simon Hönig; Franz Leisch; Clemens Steinwender
Journal:  J Interv Card Electrophysiol       Date:  2010-10-05       Impact factor: 1.900

Review 3.  [Current strategies in the treatment of atrial fibrillation].

Authors:  Imke Drewitz; Thomas Rostock; Boris Hoffmann; Daniel Steven; Helge Servatius; Thomas Meinertz; Stephan Willems
Journal:  Med Klin (Munich)       Date:  2008-11-15

4.  Surveillance of AF recurrence post-surgical AF ablation using implantable cardiac monitor.

Authors:  John H Ip; Maria Viqar-Syed; Denise Grimes; Yan Xie; Kevin Jager; Jennifer Boak; Divyakant Gandhi
Journal:  J Interv Card Electrophysiol       Date:  2011-08-04       Impact factor: 1.900

5.  [Surgical atrial fibrillation ablation therapy and postoperative monitoring].

Authors:  T Hanke; H-H Sievers
Journal:  Herz       Date:  2011-12       Impact factor: 1.443

6.  2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.

Authors:  Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane
Journal:  Heart Rhythm       Date:  2017-05-12       Impact factor: 6.343

7.  2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society.

Authors:  Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber
Journal:  Heart Rhythm       Date:  2012-03-01       Impact factor: 6.343

Review 8.  2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.

Authors:  Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane
Journal:  Europace       Date:  2018-01-01       Impact factor: 5.214

Review 9.  [ECG telemonitoring].

Authors:  Michael Oeff; Axel Müller; Jörg Neuzner; Stefan Sack; Jörg O Schwab; Dietrich Pfeiffer; Christian Zugck
Journal:  Herzschrittmacherther Elektrophysiol       Date:  2008-10-25

Review 10.  New approaches to managing nonvalvular atrial fibrillation: what are the thromboembolic implications?

Authors:  Peter J Kudenchuk
Journal:  J Thromb Thrombolysis       Date:  2015-04       Impact factor: 2.300

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