Ablation of Paroxysmal and Persistent Atrial Fibrillation: 1‐Year Follow‐Up Through Continuous Subcutaneous Monitoring

Pokushalov, Evgeny; Romanov, Alexander; Corbucci, Giorgio; Artyomenko, Sergey; Туров, А. Н.; Shirokova, Natalya; Karaskov, Alexander

doi:10.1111/j.1540-8167.2010.01923.x

Cited by 105 publications

(99 citation statements)

References 30 publications

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“…Patients without symptoms imputable to any supraventricular arrhythmia and with an AF% Ͻ0.5% at each monthly follow-up examination were considered responders. 21 On the contrary, patients with symptoms concomitant to genuine AF, AT, or atrial flutter in the ECG stored by the implanted monitor and patients without symptoms but with an AF% Ͼ0.5% in at least 1 of the monthly examination of the follow-up period were considered nonresponders, that is, patients with AF recurrence.…”

Section: Definition Of Responders Nonresponders and Af Recurrencementioning

confidence: 99%

Use of an Implantable Monitor to Detect Arrhythmia Recurrences and Select Patients for Early Repeat Catheter Ablation for Atrial Fibrillation

Pokushalov

Romanov

Corbucci

et al. 2011

Circ: Arrhythmia and Electrophysiology

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Background— Catheter ablation of atrial fibrillation (AF) has proved effective in curing highly symptomatic patients with paroxysmal AF. The aim of this prospective, randomized study was to identify the optimal treatment of patients with AF recurrences after the first ablation. Methods and Results— Two hundred eighty-six patients with paroxysmal AF underwent ablation (circumferential pulmonary vein isolation with linear lesions) and were monitored with an implantable cardiac monitor (Reveal XT, Medtronic). Patients without AF recurrences during the 3-month postablation period were assigned to group 1; those with AF recurrences to group 2. Patients in group 2 were randomly assigned to group 3 or group 4. Group 3 patients were treated only with antiarrhythmic drugs for 6 weeks, with no early reablation during the 3-month postablation period. In the case of AF recurrence after the 3-month postablation period, patients underwent reablation. Group 4 patients were treated according to the onset mechanism of AF recurrences, as detected and stored by the implantable cardiac monitor: antiarrhythmic drug therapy, but no reablation if AF was not preceded by triggers; early reablation if premature atrial beats or atrial tachycardias or flutter triggered AF. All patients were followed up for 1 year to assess maintenance of sinus rhythm in each group. On 12-month follow-up examination, of the 119 (42%) patients in group 1, 112 (94%) had no AF recurrences. Among the 83 patients in group 3, only 27 (33%) had no recurrences. Of the 84 group 4 patients, 67 (80%) had no AF recurrences ( P <0.0001 versus group 3). Conclusions— Patients with recurrences after the first AF ablation are likely to respond to a second early ablation when AF is triggered by supraventricular arrhythmias or premature contractions. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01164319.

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Section: Definition Of Responders Nonresponders and Af Recurrencementioning

confidence: 99%

Use of an Implantable Monitor to Detect Arrhythmia Recurrences and Select Patients for Early Repeat Catheter Ablation for Atrial Fibrillation

Pokushalov

Romanov

Corbucci

et al. 2011

Circ: Arrhythmia and Electrophysiology

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“…31 Results of the cryoballoon isolation of pulmonary veins are comparable. 32 These data are consistent with a meta-analysis of 63 studies that shows a recurrence rate of 43 % after a single procedure and of 29 % after repeated procedure.…”

Section: Holter Monitors and Loop Recorders In Patient Follow-upmentioning

confidence: 56%

Holter Monitoring and Loop Recorders: From Research to Clinical Practice

Galli¹,

Ambrosini²,

Lombardi³

2016

Arrhythmia &Amp; Electrophysiology Review

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Since the 1960s, Holter monitoring has been a cornerstone for diagnosing suspected arrhythmias in patients of all ages. 1 The most common monitoring systems allow the continuous registration of three or more leads for 24-48 hours; newer Holter monitors allow continuous electrocardiogram (ECG) registration for 2 weeks.1 Extending the time of ECG registration will increase the diagnostic yield of Holter monitoring, especially for those rhythm disturbances that are infrequent but recurrent.1,2 This need for a prolonged ECG monitoring has been addressed by event recorders, which can monitor patients for up to 3 years, storing the ECG obtained a few minutes before and after the onset of an arrhythmia in its memory and transmitting data to the cardiac unit. 1,2 When interpreting the results of the ECG, the cardiologist has to determine whether symptoms reported by the patient could be linked to significant disturbances in heart rhythm.2 In other circumstances the detection of atrial or ventricular arrhythmias may alert the cardiologist, even if they occur asymptomatically, thus prompting a specific therapeutic decision such as starting antiarrhythmic or anticoagulant drugs or implanting a pacemaker or a cardioverter defibrillator. Cardiac Monitoring SystemsCardiac rhythm monitoring has an established diagnostic and prognostic role in different circumstances: syncope, palpitations and monitoring of patients with known or suspected episodes of atrial fibrillation (AF), e.g. those with stroke of uncertain aetiology (cryptogenic stroke).1-3 ECG monitoring may also play a role in identifying ventricular tachycardia (VT) in patients with recognised risk of sudden cardiac death. 4 As many devices with different characteristics are available, the choice of the most suitable monitoring system largely depends on the likelihood of detecting a significant correlation between symptoms and ECG findings. Holter MonitorsTraditional ambulatory Holter monitors are simple devices that usually have three leads and continuously register the ECG. They can be short-(24-48 hours) or long-duration (1-2 weeks) devices.1 Two-week Holter monitoring is preferred when diagnosing or excluding AF in cryptogenic stroke, but loop recorders and outpatient telemetry have even higher detection rates. Loop Recorders and Post-event RecordersNewer generation monitors are the so-called event recorders.According to their specific functions they can be divided into two categories: loop recorders, which include external loop recorders (ELRs) and implantable loop recorders (ILRs); and post-event recorders (non-looping recorders). 1 AbstractHolter monitors are tools of proven efficacy in diagnosing and monitoring cardiac arrhythmias. Despite the fact their use is widely prescribed by general practitioners, little is known about their evolving role in the management of patients with cryptogenic stroke, paroxysmal atrial fibrillation, unexplained recurrent syncope and risk stratification in implantable cardioverter defibrillator or pacemaker candidates. New Holt...

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“…The LA ∆ distension at each 6 months is slower between the 18 th and the 12 th months for both groups. And finally, the LA growth distension rate per month at the end of follow-up, in comparison to 12 th month, was slower only in the AF recurrence group [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

The effects of renal sympathetic denervation in the left atrium enlargement after pulmonary vein isolation

Kiuchi¹,

Chen²,

Paz³

et al. 2017

J Integr Cardiol

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Ablation of Paroxysmal and Persistent Atrial Fibrillation: 1‐Year Follow‐Up Through Continuous Subcutaneous Monitoring

Cited by 105 publications

References 30 publications

Use of an Implantable Monitor to Detect Arrhythmia Recurrences and Select Patients for Early Repeat Catheter Ablation for Atrial Fibrillation

Use of an Implantable Monitor to Detect Arrhythmia Recurrences and Select Patients for Early Repeat Catheter Ablation for Atrial Fibrillation

Holter Monitoring and Loop Recorders: From Research to Clinical Practice

The effects of renal sympathetic denervation in the left atrium enlargement after pulmonary vein isolation

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