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Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation

Alhede, Christina; Johannessen, Arne; Dixen, Ulrik; Jensen, Jan S.; Raatikainen, Pekka; Hindricks, Gerhard; Walfridsson, Håkan; Kongstad, Ole; Pehrson, Steen LU and Englund, Anders, et al. (2018) In Europace 20(1). p.50-57
Abstract

Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and≥783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF≥1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month... (More)

Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and≥783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF≥1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (≥783 SVEC: HR 4.6 [1.9-11.5], P<0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence<90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC≥213: HR 3.0 [1.3-6.7], P=0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period. Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.

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type
Contribution to journal
publication status
published
subject
keywords
Arrhythmia, Atrial fibrillation, Atrial premature complexes, Recurrence, Treatment
in
Europace
volume
20
issue
1
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:85040770698
ISSN
1099-5129
DOI
10.1093/europace/euw329
language
English
LU publication?
no
id
6fee2e3c-81df-4412-b077-572c82fb8a3c
date added to LUP
2018-02-05 11:09:24
date last changed
2018-06-24 05:20:20
@article{6fee2e3c-81df-4412-b077-572c82fb8a3c,
  abstract     = {<p>Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and≥783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF≥1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (≥783 SVEC: HR 4.6 [1.9-11.5], P&lt;0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence&lt;90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC≥213: HR 3.0 [1.3-6.7], P=0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period. Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.</p>},
  author       = {Alhede, Christina and Johannessen, Arne and Dixen, Ulrik and Jensen, Jan S. and Raatikainen, Pekka and Hindricks, Gerhard and Walfridsson, Håkan and Kongstad, Ole and Pehrson, Steen and Englund, Anders and Hartikainen, Juha and Hansen, Peter Steen and Nielsen, Jens C. and Jons, Christian},
  issn         = {1099-5129},
  keyword      = {Arrhythmia,Atrial fibrillation,Atrial premature complexes,Recurrence,Treatment},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {50--57},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation},
  url          = {http://dx.doi.org/10.1093/europace/euw329},
  volume       = {20},
  year         = {2018},
}