Burden and Long Firing of Premature Atrial Contraction Early After Catheter Ablation Predict Late Recurrence of Atrial Fibrillation.

Abstract

BACKGROUND:

Associations between characteristics of premature atrial contraction (PAC) 6 months after catheter ablation (CA) and later recurrence are not known. We investigated the effects of PAC characteristics on long-term outcomes of initially successful atrial fibrillation (AF) ablation.Methods and Results:In all, 378 patients (mean age 61 years, 21% female, 67% paroxysmal AF) who underwent initial radiofrequency CA for AF without recurrence up to 24-h Holter monitoring 6 months after the procedure were reviewed retrospectively. The calculated number of PAC/24 h and the length of the longest PAC run during Holter recording were analyzed. After 4.3±1.2 years (mean±SD) follow-up, 123 (32.5%) patients experienced late recurrence. Patients with recurrence had significantly more PAC/24 h (median [interquartile range] 110 [33-228] vs. 42 [16-210]; P<0.01) and a longer longest PAC run (5 [2-8] vs. 3 [1-5]; P<0.01) than those without. Receiver operating characteristic curve analysis indicated 58 PAC/24 h and a longest PAC run of 5 were optimal cut-off values for predicting recurrence. After adjusting for previously reported predictors of late recurrence, frequent PAC (≥58/24 h) and longest PAC run ≥5 were found to be independent predictors of late recurrence (hazard ratios [95% confidence intervals] 1.93 [1.24-3.02; P<0.01] and 1.81 [1.20-2.76; P<0.01], respectively).

CONCLUSIONS:

Six months after successful AF ablation, both frequent PAC and long PAC run are independent predictors of late recurrence.

• Authors: Hiroyuki Inoue, Nobuaki Tanaka, Koji Tanaka, Yuichi Ninomiya, Yuko Hirao, Takafumi Oka, Masato Okada, Ryo Kitagaki, Kohtaro Takayasu, Yasushi Koyama, Atsunori Okamura, Katsuomi Iwakura, Kenshi Fujii, Yasushi Sakata, Koichi Inoue
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 84 Issue 6 Pg. 894-901 (05 25 2020) ISSN: 1347-4820 [Electronic] Japan
• PMID: 32188830 (Publication Type: Journal Article, Observational Study)

Topics

• Action Potentials
• Aged
• Atrial Fibrillation (diagnosis, physiopathology, surgery)
• Atrial Premature Complexes (diagnosis, etiology, physiopathology)
• Catheter Ablation (adverse effects)
• Female
• Heart Rate
• Humans
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Time Factors
• Treatment Outcome