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Evaluation of atrial fibrillation burden before catheter ablation predicts outcome after pulmonary vein isolation.

Berkowitsch A, Neumann T, Kuniss M, Brandt R, Zaltsberg S, Pitschner HF - Indian Pacing Electrophysiol J (2009)

Bottom Line: Symptomatic AFB was found to be appropriate for prediction of outcome after PVI.Low AFB < 500 h /3 months was associated with better outcome after PVI.Patients with PAF and high AFB should be treated as patients with PersAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. a.berkowitsch/at/kerckhoff-klinik.de

ABSTRACT

Background: Paroxysmal atrial fibrillation (PAF) is defined as recurrent AF terminating spontaneously within 7 days. This definition allows the consideration of any AF occurrence lasting < 7 days as paroxysmal, irrespective of the frequency and duration of episodes. The aim of this study was to investigate symptomatic AF burden (AFB) defined as total duration of symptomatic AF episodes within 3 months prior to abalation, for prediction of outcome after pulmonary vein isolation (PVI).

Methods: A total of 320 consecutive patients with symptomatic AF (PAF=244, men=214, age=58 y) were enrolled. AFB in patients with PAF was defined as time spent in AF within 3 months prior to PVI. After the AFB cut-off point was optimized at 500 h, patients with PAF were categorized into 2 groups: Group 1 - patients with AFB< 500 h (n=192), Group 2 - patients with AFB> or = 500 h (n=52). Patients with persistent AF (PersAF, n = 76) comprised control group (Group 3). PVI was performed either with irrigated tip catheter (n=215) or using cryoballoon (n=105). The endpoint of study was first documented recurrence of AF >30 sec.

Results: Symptomatic AFB was found to be appropriate for prediction of outcome after PVI. The freedom from AF within 2 years was observed in 69%, 31%, and 43% patients in Group 1, 2 and 3, respectively (Group 1 vs. Group 2, p < .001; Group 1 vs. Group 3, p< .001; Group 2 vs. Group 3, p = 0.46).

Conclusions: Low AFB < 500 h /3 months was associated with better outcome after PVI. Patients with PAF and high AFB should be treated as patients with PersAF.

No MeSH data available.


Related in: MedlinePlus

Outcome after catheter ablation in different AF groups.Group 1-paroxysmal AF with AF burden < 500 hours/3 months;Group 2-paroxysmal AF with AF burden ≥ 500 hours/3 months;Group 3-persistent AF
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Figure 2: Outcome after catheter ablation in different AF groups.Group 1-paroxysmal AF with AF burden < 500 hours/3 months;Group 2-paroxysmal AF with AF burden ≥ 500 hours/3 months;Group 3-persistent AF

Mentions: Out of 320 enrolled patients, 182 (57 %) were free of documented AF recurrence during 2-year follow-up. Kaplan-Meier survival analysis has shown that dichotomized AF burden was strongly associated with outcome (Figure 2). The log-rank test demonstrated significant differences in the likelihood of AF recurrence between Group 1 (n=192), and Group 2(n=52) (χ2=26.11, p< .001), and Group 3 (n=76) (χ2=20.17, p< .001). Of note, no significant difference between Group 2 and Group 3 was found (χ2=2.43, p=.46).


Evaluation of atrial fibrillation burden before catheter ablation predicts outcome after pulmonary vein isolation.

Berkowitsch A, Neumann T, Kuniss M, Brandt R, Zaltsberg S, Pitschner HF - Indian Pacing Electrophysiol J (2009)

Outcome after catheter ablation in different AF groups.Group 1-paroxysmal AF with AF burden < 500 hours/3 months;Group 2-paroxysmal AF with AF burden ≥ 500 hours/3 months;Group 3-persistent AF
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683634&req=5

Figure 2: Outcome after catheter ablation in different AF groups.Group 1-paroxysmal AF with AF burden < 500 hours/3 months;Group 2-paroxysmal AF with AF burden ≥ 500 hours/3 months;Group 3-persistent AF
Mentions: Out of 320 enrolled patients, 182 (57 %) were free of documented AF recurrence during 2-year follow-up. Kaplan-Meier survival analysis has shown that dichotomized AF burden was strongly associated with outcome (Figure 2). The log-rank test demonstrated significant differences in the likelihood of AF recurrence between Group 1 (n=192), and Group 2(n=52) (χ2=26.11, p< .001), and Group 3 (n=76) (χ2=20.17, p< .001). Of note, no significant difference between Group 2 and Group 3 was found (χ2=2.43, p=.46).

Bottom Line: Symptomatic AFB was found to be appropriate for prediction of outcome after PVI.Low AFB < 500 h /3 months was associated with better outcome after PVI.Patients with PAF and high AFB should be treated as patients with PersAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. a.berkowitsch/at/kerckhoff-klinik.de

ABSTRACT

Background: Paroxysmal atrial fibrillation (PAF) is defined as recurrent AF terminating spontaneously within 7 days. This definition allows the consideration of any AF occurrence lasting < 7 days as paroxysmal, irrespective of the frequency and duration of episodes. The aim of this study was to investigate symptomatic AF burden (AFB) defined as total duration of symptomatic AF episodes within 3 months prior to abalation, for prediction of outcome after pulmonary vein isolation (PVI).

Methods: A total of 320 consecutive patients with symptomatic AF (PAF=244, men=214, age=58 y) were enrolled. AFB in patients with PAF was defined as time spent in AF within 3 months prior to PVI. After the AFB cut-off point was optimized at 500 h, patients with PAF were categorized into 2 groups: Group 1 - patients with AFB< 500 h (n=192), Group 2 - patients with AFB> or = 500 h (n=52). Patients with persistent AF (PersAF, n = 76) comprised control group (Group 3). PVI was performed either with irrigated tip catheter (n=215) or using cryoballoon (n=105). The endpoint of study was first documented recurrence of AF >30 sec.

Results: Symptomatic AFB was found to be appropriate for prediction of outcome after PVI. The freedom from AF within 2 years was observed in 69%, 31%, and 43% patients in Group 1, 2 and 3, respectively (Group 1 vs. Group 2, p < .001; Group 1 vs. Group 3, p< .001; Group 2 vs. Group 3, p = 0.46).

Conclusions: Low AFB < 500 h /3 months was associated with better outcome after PVI. Patients with PAF and high AFB should be treated as patients with PersAF.

No MeSH data available.


Related in: MedlinePlus