Early recurrences of atrial tachyarrhythmias post pulmonary vein isolation.

von Olshausen, Gesa; Uijl, Alicia; Jensen-Urstad, Mats; Schwieler, Jonas; Drca, Nikola; Bastani, Hamid; Tapanainen, Jari; Saluveer, Ott; Bourke, Tara; Kennebäck, Göran; Insulander, Per; Deisenhofer, Isabel; Braunschweig, Frieder

doi:10.1111/jce.14368

journal article

Document type:: Article; Journal Article; Research Support, Non-U.S. Gov't
Author(s):: von Olshausen, Gesa; Uijl, Alicia; Jensen-Urstad, Mats; Schwieler, Jonas; Drca, Nikola; Bastani, Hamid; Tapanainen, Jari; Saluveer, Ott; Bourke, Tara; Kennebäck, Göran; Insulander, Per; Deisenhofer, Isabel; Braunschweig, Frieder
Title:: Early recurrences of atrial tachyarrhythmias post pulmonary vein isolation.
Abstract:: AIMS: To investigate the significance of early recurrence (ER) of atrial tachyarrhythmias after pulmonary vein isolation (PVI) on the development of late recurrence (LR) and to redefine the blanking period during which an ER is considered nonspecific. METHODS: Data of 713 patients undergoing their first PVI for paroxysmal or persistent atrial fibrillation between January 2012 and December 2017 were included. All patients were followed-up for 12 months according to clinical and outpatient routine and were screened for any atrial tachyarrhythmia lasting >30 seconds occurring during the first 3 months postablation (ER) and after the 3 months blanking period (LR). RESULTS: Patients with ER compared to those without ER had significantly more LR (74.5% vs 16.5% vs, P < .001). The occurrence of ER during the first, second and third months showed increasing LR rates of 35.2%, 67.9%, and 94.8%, respectively (P < .001). Receiver operator characteristic analysis revealed a blanking period of 46 days with the highest sensitivity (68.1%) and specificity (96.5%). Later timing and longer time span of ER were independent predictors for LR in multivariable analysis. CONCLUSION: ER is a strong predictor for LR. Our study advocates a shortening of the post-PVI blanking period followed by a "gray zone" up to 3 months where individualized therapeutic decisions based on additional risk factors should be considered. We suggest that the ER time span might serve as such a predictor identifying patients at the highest risk for LR.
Journal title abbreviation:: J Cardiovasc Electrophysiol
Year:: 2020
Journal volume:: 31
Journal issue:: 3
Pages contribution:: 674-681
Fulltext / DOI:: doi:10.1111/jce.14368
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/31984563
Print-ISSN:: 1045-3873
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2020