Electrical cardioversion for early recurrences post pulmonary vein isolation.

von Olshausen, Gesa; Paul-Nordin, Astrid; Tapanainen, Jari; Jensen-Urstad, Mats; Bastani, Hamid; Saluveer, Ott; Bourke, Tara; Drca, Nikola; Kennebäck, Göran; Saygi, Serkan; Turkmen, Yusuf; Insulander, Per; Braunschweig, Frieder

doi:10.1007/s10840-022-01368-w

2023

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Titel:: Electrical cardioversion for early recurrences post pulmonary vein isolation.
Dokumenttyp:: Journal Article
Autor(en):: von Olshausen, Gesa; Paul-Nordin, Astrid; Tapanainen, Jari; Jensen-Urstad, Mats; Bastani, Hamid; Saluveer, Ott; Bourke, Tara; Drca, Nikola; Kennebäck, Göran; Saygi, Serkan; Turkmen, Yusuf; Insulander, Per; Braunschweig, Frieder
Abstract:: BACKGROUND: To study the association between timing and success of electrical cardioversion (ECV) for the treatment of early recurrences (ERs) of atrial fibrillation post pulmonary vein isolation (PVI) on long-term rhythm outcome. METHODS: Data of 133 patients ablated for paroxysmal or persistent atrial fibrillation receiving ECV for ERs, i.e., atrial tachyarrhythmia recurrences within 90 days post ablation were analyzed. During 1-year follow-up, patients were screened for late recurrences (LRs), i.e., recurrences after the blanking period. RESULTS: In 114 patients (85.7%), ECV was successful compared to 19 patients (14.3%) with failed ECV. A higher body mass index (odds ratio (OR) 1.19 (95% CI 1.02-1.39), p = 0.029), a lower left ventricular ejection fraction (OR 1.07 (95% CI 0.99-1.15), p = 0.079), and performance of ECV > 7 days from ER onset (OR 2.99 (95% CI 1.01-8.87), p = 0.048) remained independently associated with ECV failure. During 1-year follow-up, the rate of LR was significantly higher among patients with failed ECV as compared to patients with successful ECV (hazard ratio (HR) 3.00 (95% CI, 1.79-5.03), p < 0.001). Patients with ECV performed > 7 days from ER onset had a significantly higher risk of developing LR as compared to patients with ECV performed within ≤ 7 days from ER onset (HR 1.73 (95% CI 1.15-2.62), p = 0.009). Performance of ECV > 7 days from ER onset (HR 1.76 (95% CI 1.16-2.67), p = 0.008) and failed ECV (HR 3.32 (95% CI 1.96-5.64), p < 0.001) remained independently associated with LR. CONCLUSIONS: A failed ECV and performance of ECV > 7 days from ER onset were independently associated with LR.
Zeitschriftentitel:: J Interv Card Electrophysiol
Jahr:: 2023
Band / Volume:: 66
Heft / Issue:: 3
Seitenangaben Beitrag:: 577-584
Volltext / DOI:: doi:10.1007/s10840-022-01368-w
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/36085243
Print-ISSN:: 1383-875X
TUM Einrichtung:: Klinik und Poliklinik für Innere Medizin I, Kardiologie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2023