Redefining the Blanking Period After Catheter Ablation for Paroxysmal Atrial Fibrillation
- 1 August 2016
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Arrhythmia and Electrophysiology
Abstract
Background—: Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results—: A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia ≥30 s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6%) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2% in patients without ER compared with 62.6%, 36.4%, and 7.8% in patients with ER 1, 2, and 3 months post ablation, respectively ( P P 90% of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01058980.Keywords
This publication has 29 references indexed in Scilit:
- Impact of Adenosine-Provoked Acute Dormant Pulmonary Vein Conduction on Recurrence of Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2011
- Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study)Circulation: Arrhythmia and Electrophysiology, 2011
- Upstream therapies for management of atrial fibrillation: review of clinical evidence and implications for European Society of Cardiology guidelines. Part II: secondary preventionEP Europace, 2011
- Renin‐Angiotensin System Blocker Use May Be Associated with Suppression of Atrial Fibrillation Recurrence after Pulmonary Vein IsolationPacing and Clinical Electrophysiology, 2010
- Persistence of Pulmonary Vein Isolation After Robotic Remote‐Navigated Ablation for Atrial Fibrillation and its Relation to Clinical OutcomeJournal of Cardiovascular Electrophysiology, 2010
- Prevalence, Predictors, and Prognosis of Atrial Fibrillation Early After Pulmonary Vein Isolation: Findings from 3 Months of Continuous Automatic ECG Loop RecordingsJournal of Cardiovascular Electrophysiology, 2009
- Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study)Circulation, 2009
- Revisiting youden's index as a useful measure of the misclassification error in meta-analysis of diagnostic studiesStatistical Methods in Medical Research, 2008
- Response of Atrial Fibrillation to Pulmonary Vein Antrum Isolation Is Directly Related to Resumption and Delay of Pulmonary Vein ConductionCirculation, 2005
- Clinical significance of early recurrences of atrial fibrillation after pulmonary vein isolationJournal of the American College of Cardiology, 2002