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Forkmann, Mathias; Schwab, Carolina; Edler, Daniela; Vevecka, Aneida; Butz, Steffi; Haller, Bernhard; Brachmann, Johannes; Busch, Sonia

Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation

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  • Media type: E-Article
  • Title: Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation
  • Contributor: Forkmann, Mathias; Schwab, Carolina; Edler, Daniela; Vevecka, Aneida; Butz, Steffi; Haller, Bernhard; Brachmann, Johannes; Busch, Sonia
  • imprint: Wiley, 2019
  • Published in: Journal of Cardiovascular Electrophysiology
  • Language: English
  • DOI: 10.1111/jce.14109
  • ISSN: 1045-3873; 1540-8167
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>Early recurrences (ER) of atrial arrhythmias are common after catheter ablation of atrial fibrillation (AF). The significance of these ER is controversial.</jats:p><jats:p>Based on data of continuous cardiac monitoring, we sought to investigate the characteristics of ER and their impact on late recurrences (LR) during follow‐up.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>One hundred twenty‐six patients with paroxysmal (49%) or persistent (51%) AF underwent an AF ablation with subsequent implantation of implantable loop recorder. Follow up was 12 months using remote monitoring. All atrial arrhythmia (AF or atrial tachycardia‐AT‐) episodes &gt;30 seconds. within the 3‐month blanking period were considered and the AF burden evaluated every 3 months.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within the 3‐months blanking period, 72 patients (57%) experienced an AF/AT recurrence. Survival free from any arrhythmia recurrence during follow‐up was 40% in patients with ER vs 69% in those without ER. AF burden during the blanking period and timing of ER correlated significantly with LR at 12 months (area under curve = 0.74, <jats:italic>P</jats:italic> &lt; .0001 and .831, <jats:italic>P</jats:italic> &lt; .0001). An AF burden ≥0.5% and ER after 74 days predicted LR (sensitivity 60%, specificity 84.4%; sensitivity 75.6%, specificity 90.3%). In cox regression analysis, AF burden ≥0.5% and ER after 74 days were independently associated with LR.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Continuous cardiac monitoring after AF ablation provides important information regarding early recurrence episodes and their prognostic impact. A cut‐off of 74 days for the blanking period seems to better differentiate patients with a good or a poor long‐term outcome. An AF burden ≥0.5% during the 3 months postablation is predictive for late arrhythmia recurrences.</jats:p></jats:sec>