Clinical significance of early recurrence after pulmonary vein antrum isolation in paroxysmal atrial fibrillation -- insight into the mechanism

Circulation Journal : Official Journal of the Japanese Circulation Society
Shinsuke MiyazakiYoshito Iesaka

Abstract

Early recurrence of atrial fibrillation (ERAF) is common after pulmonary vein antrum isolation (PVAI); however, the definition, study population, and lesion set are not uniform in prior studies. We examined ERAF for paroxysmal AF while complying with the definition in the latest guidelines. We included 471 patients undergoing empirical PVAI for paroxysmal AF. ERAF was observed in 180 patients (38.2%) including 49, 16, and 115 within 3, 4-7 days, and 8-90 days, respectively, after the index procedure. ERAF (hazard ratio 6.872; 95% confidence interval 4.803-9.382; P<0.0001) was the strongest factor associated with recurrence beyond 3 months (LR) in the multivariable model, and ERAF patients had worse outcomes than those without, regardless of the time to the first ERAF episode. There were no significant differences in the prevalence of PV reconnections and non-PV foci among 29 and 62 patients, respectively, who underwent redo procedures for ERAF within and more than 3 months after the index procedure, and 21 who underwent redo procedures for LR. Re-ablation was associated with a greater freedom from LR (HR 0.443; 95% CI 0.230-0.854; P=0.015). ERAF occurred in 38.2% of patients and was strongly associated with LR regardless of the...Continue Reading

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Citations

Mar 5, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Kentaro HayashiMasahiko Goya
May 20, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Yan YaoChang-Sheng Ma
Nov 20, 2016·Journal of Cardiovascular Electrophysiology·Yuhi FujimotoWataru Shimizu
Feb 26, 2019·The Journal of International Medical Research·Yubing WangYuehui Yin
May 3, 2019·Pacing and Clinical Electrophysiology : PACE·Wei-Chieh LeeMien-Cheng Chen
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Nov 27, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hugh CalkinsDouglas L Packer
Nov 21, 2020·The American Journal of Cardiology·Yasuyuki EgamiJun Tanouchi
Jul 3, 2021·Journal of Clinical Medicine·Jan BudzianowskiKatarzyna Korybalska

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