Recurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto‐trigger function

Kawasaki, Shiro; Tanno, Kaoru; Ochi, Akinori; Inokuchi, Kaoru; Chiba, Yuta; Onishi, Yuki; Onuma, Yoshimasa; Munetsugu, Yumi; Kikuchi, Miwa; Ito, Hiroyuki; Onuki, Tatsuya; Miyoshi, Fumito; Minoura, Yoshino; Watanabe, Norikazu; Adachi, Taro; Asano, Taku; Kobayashi, Youichi

doi:10.1016/j.joa.2014.08.002

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…A previous study using a pacemaker interrogation or external loop recorder demonstrated that the duration of asymptomatic atrial high frequency episodes after PVI were significantly shorter than the duration of the symptomatic ones [8] , [9] , [19] , [21] . These atrial high frequency episodes were short in duration (<60 s) and largely waned after 3 months [9] .…”

Section: Discussionmentioning

confidence: 90%

The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

Osaka

Takigawa

Takahashi

et al. 2017

Indian Pacing and Electrophysiology Journal

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BackgroundCatheter ablation (CA) of paroxysmal atrial fibrillation (PAF) is an effective treatment. However, the frequency of asymptomatic AF recurrence after CA in patients with PAF and sick sinus syndrome (SSS) is not clear. The aim of this study was to elucidate the real AF recurrence after CA in patients with PAF and a pacemaker for SSS.Methods and resultsFifty-one consecutive patients (mean age 66.6 ± 7.0 years, male 34) with PAF and SSS and pacemakers underwent CA. All patients were followed at 1, 3, 6, 9, and 12 months after the CA using a 12-lead ECG, Holter-ECG, and 1-month event recorder as a conventional follow-up. In addition, the pacemakers were interrogated every 12 months. During a 5-year follow-up after the final CA procedure, AF recurrences were observed in 7 patients (13.7%) with a conventional follow-up, including 1 (2.0%) asymptomatic patient. Pacemaker-interrogation revealed another 10 patients (19.6%) with asymptomatic AF recurrences. Ultimately, the conventional follow-up plus pacemaker-interrogation provided a higher incidence of AF recurrences (P = 0.009). Multiple CA procedures contributed to a significant increase in the AF-free survival rate at 5 years: 58.6% after a single CA and 86.0% after multiple CA procedures with a conventional follow-up, but which decreased to 40.6% and 60.9% with a conventional follow-up plus a pacemaker interrogation, respectively.ConclusionsOne-third of PAF patients with SSS and pacemakers recurred after multiple CA sessions. However, 65% of them were asymptomatic and difficult to be identified with conventional follow-up. Pacemaker interrogation significantly increased the detection rate of AF-recurrence.

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Section: Discussionmentioning

confidence: 90%

The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

Osaka

Takigawa

Takahashi

et al. 2017

Indian Pacing and Electrophysiology Journal

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“…Long-term ECG monitoring options for AF are being explored using implantable devices and non-invasive external recorders. However, implantable devices are expensive and not covered by health insurance, and non-invasive recorders often provide false positives or are otherwise unreliable [9,19,20]. Wearable patch-type devices with embedded adhesive gel electrodes are non-invasive, relatively inexpensive, and capable of recording for up to 14 days, but the gel electrode becomes unusable if the patch peels off, which generally limits use to 7 days or less [10,11].…”

Section: Discussionmentioning

confidence: 99%

Randomized crossover trial of 2-week Garment electrocardiogram with dry textile electrode to reveal instances of post-ablation recurrence of atrial fibrillation underdiagnosed during 24-hour Holter monitoring

et al. 2023

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Background Atrial fibrillation (AF) is the most common arrhythmia and often recurs despite catheter ablation. The recurrence of AF is often underdiagnosed by standard 24-hour electrocardiogram (ECG) because of its transient and silent nature. A garment-style ECG with a highly conductive textile electrode made of poly(3,4-ethylenedioxythiophene) poly(styrenesulfonate)(PEDOTPSS) and nanofiber (Garment ECG) has been developed that can provide longer-term continuous monitoring. This study investigated whether 2-week Garment ECG can reveal instances of AF recurrence in patients who are diagnosed as remaining in sinus rhythm by 24-hour Holter ECG. Methods The open-label randomized crossover study enrolled 67 patients (63.1±10.6 years old, 53 men) who had undergone initial AF ablation. Three months after ablation, patients were randomly assigned to group 1 (n = 35), 2-week Garment ECG followed by 24-hour Holter ECG, or group 2 (n = 32), 24-hour Holter ECG followed by 2-week Garment ECG. The detection of AF recurrence was compared between the two devices. Results The Garment ECG showed AF recurrence in 12 patients (18%) compared to 4 patients for the Holter ECG (6%, p = 0.008). The ECG acquisition rate was higher for Holter ECG than for Garment ECG (100.0% [interquartile range 100.0–100.0%] versus 82.4% [71.1–91.0%], p<0.001), but the Garment ECG provided longer total analysis time (11.0 days [9.0–12.2 days] for Garment; 1.0 day [1.0–1.0 day] for Holter, p<0.001). Conclusions Despite the lower ECG acquisition rate, the 2-week Garment ECG revealed instances of AF recurrence after ablation in patients who were underdiagnosed by 24-hour Holter ECG. Trial registration Clinical Trial Registration: URL: https://jrct.niph.go.jp/en-latest-detail/jRCTs032180018 Unique Identifier: jRCTs032180018.

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“…In some patients, recurrence of AF might have been missed due to lack of symptoms and non-continuous monitoring for AF. Follow-up duration of 3 months could be a limitation as well; however, a previous study has shown that recurrence within 3 months is also predictive for late recurrence of AF [38]. Taken together, validation in a multi-center cohort with more stringent conditions for mapping protocols as well as event monitoring may be required to provide more robust evidence on the results and minimize possible bias.…”

Section: Limitationsmentioning

confidence: 99%

3D Atrial Strain for Predicting Recurrence of Atrial Fibrillation after Pulmonary Vein Isolation

Krizanovic-Grgic

Anwer

Steffel

et al. 2023

JCM

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Aims: Association of two-(2D) and three-dimensional (3D) left atrial strain (LAS) and low-voltage area (LVA) with recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) was assessed. Methods and results: 3D LAS, 2D LAS, and LVA were obtained in 93 consecutive patients undergoing PVI and recurrence of AF was analyzed prospectively. AF recurred in 12 patients (13%). The 3D left atrial reservoir strain (LARS) and pump strain (LAPS) were lower in patients with recurrent AF than without (p = 0.008 and p = 0.009, respectively). In univariable Cox regression, 3D LARS or LAPS were associated with recurrent AF (LARS: HR = 0.89 (0.81–0.99), p = 0.025; LAPS: HR = 1.40 (1.02–1.92), p = 0.040), while other values were not. Association of 3D LARS or LAPS with recurrent AF was independent of age, body mass index, arterial hypertension, left ventricular ejection fraction, and end-diastolic volume index and left atrial volume index in multivariable models. Kaplan–Meier curves revealed that patients with 3D LAPS < −5.9% did not exhibit recurrent AF, while those >−5.9% had a significant risk of recurrent AF. Conclusions: 3D LARS and LAPS were associated with recurrent AF after PVI. Association of 3D LAS was independent of relevant clinical and echocardiographic parameters and improved their predictive value. Hence, they may be applied for outcome prediction in patients undergoing PVI.

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Recurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto‐trigger function

Abstract: AF recurrence measured by ELR-AUTO within 3 months after PVI can predict the late recurrence of AF. Freedom from AF in the first 3 months following ablation significantly predicts long-term AF freedom. ELR-AUTO is useful for the detection of symptomatic and asymptomatic AF.

Cited by 6 publications

References 19 publications

The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

Randomized crossover trial of 2-week Garment electrocardiogram with dry textile electrode to reveal instances of post-ablation recurrence of atrial fibrillation underdiagnosed during 24-hour Holter monitoring

3D Atrial Strain for Predicting Recurrence of Atrial Fibrillation after Pulmonary Vein Isolation

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