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Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation

Alhede, Christina; Lauridsen, Trine K.; Johannessen, Arne; Dixen, Ulrik; Jensen, Jan S.; Raatikainen, Pekka; Hindricks, Gerhard; Walfridsson, Haakan; Kongstad, Ole LU and Pehrson, Steen LU , et al. (2017) In International Journal of Cardiology 244. p.186-191
Abstract

Background Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24 months of follow-up. Methods Patients with paroxysmal AF (N = 260) enrolled in the MANTRA PAF trial were treated with AAD (N = 132) or CA (N = 128). At baseline and 3, 6, 12, 18 and 24 months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF... (More)

Background Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24 months of follow-up. Methods Patients with paroxysmal AF (N = 260) enrolled in the MANTRA PAF trial were treated with AAD (N = 132) or CA (N = 128). At baseline and 3, 6, 12, 18 and 24 months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test. Results Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6–58] versus CA: 39 [14–125], p = 0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3 months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24 months of follow-up. Conclusion AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.

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publication status
published
subject
keywords
Ablation, Arrhythmia, Premature ectopic beats, Recurrence, Treatment
in
International Journal of Cardiology
volume
244
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85018869747
ISSN
0167-5273
DOI
10.1016/j.ijcard.2017.05.028
language
English
LU publication?
no
id
9ab726fd-3a85-4599-8d5b-28a069eacb34
date added to LUP
2017-11-28 10:26:12
date last changed
2018-02-18 05:05:35
@article{9ab726fd-3a85-4599-8d5b-28a069eacb34,
  abstract     = {<p>Background Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24 months of follow-up. Methods Patients with paroxysmal AF (N = 260) enrolled in the MANTRA PAF trial were treated with AAD (N = 132) or CA (N = 128). At baseline and 3, 6, 12, 18 and 24 months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test. Results Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6–58] versus CA: 39 [14–125], p = 0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3 months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24 months of follow-up. Conclusion AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.</p>},
  author       = {Alhede, Christina and Lauridsen, Trine K. and Johannessen, Arne and Dixen, Ulrik and Jensen, Jan S. and Raatikainen, Pekka and Hindricks, Gerhard and Walfridsson, Haakan and Kongstad, Ole and Pehrson, Steen and Englund, Anders and Hartikainen, Juha and Hansen, Peter S. and Nielsen, Jens C. and Jons, Christian},
  issn         = {0167-5273},
  keyword      = {Ablation,Arrhythmia,Premature ectopic beats,Recurrence,Treatment},
  language     = {eng},
  month        = {10},
  pages        = {186--191},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation},
  url          = {http://dx.doi.org/10.1016/j.ijcard.2017.05.028},
  volume       = {244},
  year         = {2017},
}