INTRODUCTION: Early arrhythmia recurrences are common within the first month after atrial fibrillation (AF) ablation. The long-term consequences of these early recurrences (ER) are controversial. We investigated whether ER were predictive of late recurrences and the impact of early reablation on clinical outcome. METHODS: Three hundred two consecutive patients with paroxysmal or persistent AF were studied. Arrhythmia recurrence was defined as documented episode of AF or atrial tachycardia. Of 151 patients with ER, a subset of 61 patients had reablation within the first month following the index ablation (early reablation). In the remaining 90 patients, a repeat procedure was only performed for later arrhythmia recurrences occurring beyond 1 month. Patients were followed with clinical interview and ambulatory 24 hours monitoring. RESULTS: Patients with and without early reablation had similar baseline characteristics including echocardiographic parameters and type of AF. During a mean follow-up of 11 +/- 11 months, 82 patients (91%) without early reablation experienced late clinical recurrences. In contrast, patients with early reablation had lower rate of clinical recurrences (51% vs 91%, P < 0.0001) and fewer additional procedures (36% vs 91%, P < 0.0001). However, the total number of procedures over the entire follow-up was greater in those patients with early reablation (2.5 +/- 0.7 vs 2.2 +/- 0.6, P = 0.02). CONCLUSION: An overwhelming majority of patients with recurrences within the first month after ablation have late recurrences. An early reablation reduces the incidence of further recurrences. However, the overall number of procedures is higher in the medium-term follow-up. The optimal timing for the second procedure remains to be defined.
INTRODUCTION: Early arrhythmia recurrences are common within the first month after atrial fibrillation (AF) ablation. The long-term consequences of these early recurrences (ER) are controversial. We investigated whether ER were predictive of late recurrences and the impact of early reablation on clinical outcome. METHODS: Three hundred two consecutive patients with paroxysmal or persistent AF were studied. Arrhythmia recurrence was defined as documented episode of AF or atrial tachycardia. Of 151 patients with ER, a subset of 61 patients had reablation within the first month following the index ablation (early reablation). In the remaining 90 patients, a repeat procedure was only performed for later arrhythmia recurrences occurring beyond 1 month. Patients were followed with clinical interview and ambulatory 24 hours monitoring. RESULTS:Patients with and without early reablation had similar baseline characteristics including echocardiographic parameters and type of AF. During a mean follow-up of 11 +/- 11 months, 82 patients (91%) without early reablation experienced late clinical recurrences. In contrast, patients with early reablation had lower rate of clinical recurrences (51% vs 91%, P < 0.0001) and fewer additional procedures (36% vs 91%, P < 0.0001). However, the total number of procedures over the entire follow-up was greater in those patients with early reablation (2.5 +/- 0.7 vs 2.2 +/- 0.6, P = 0.02). CONCLUSION: An overwhelming majority of patients with recurrences within the first month after ablation have late recurrences. An early reablation reduces the incidence of further recurrences. However, the overall number of procedures is higher in the medium-term follow-up. The optimal timing for the second procedure remains to be defined.
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
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
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
Authors: Dana C Peters; John V Wylie; Thomas H Hauser; Reza Nezafat; Yuchi Han; Jeong Joo Woo; Jason Taclas; Kraig V Kissinger; Beth Goddu; Mark E Josephson; Warren J Manning Journal: JACC Cardiovasc Imaging Date: 2009-03