Universität zu Köln

Willems, Stephan, Khairy, Paul, Andrade, Jason G., Hoffmann, Boris A., Levesque, Sylvie, Verma, Atul, Weerasooriya, Rukshen, Novak, Paul, Arentz, Thomas, Deisenhofer, Isabel, Rostock, Thomas, Steven, Daniel, Rivard, Lena, Guerra, Peter G., Dyrda, Katia, Mondesert, Blandine, Dubuc, Marc, Thibault, Bernard, Talajic, Mario ORCID: 0000-0001-8469-4748, Roy, Denis, Nattel, Stanley ORCID: 0000-0002-5565-3311 and Macle, Laurent (2016). Redefining the Blanking Period After Catheter Ablation for Paroxysmal Atrial Fibrillation Insights From the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial. Circ.-Arrhythmia Electrophysiol., 9 (8). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1941-3084

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Abstract

Background-Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results-A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia >= 30s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6%) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2% in patients without ER compared with 62.6%, 36.4%, and 7.8% in patients with ER 1, 2, and 3 months post ablation, respectively (P<0.0001). Receiver operating curve analyses revealed a strong correlation between the timing of ER and late recurrence (area under the curve 0.82, P<0.0001). Corresponding hazard ratios for ER during the first, second, and third months were 1.84, 4.45, and 9.64, respectively. Conclusions-This study validates the use of a blanking period after catheter ablation for paroxysmal atrial fibrillation but calls into question the 90-day cut-off value. In particular, >90% of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Khairy, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Andrade, Jason G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Levesque, Sylvie UNSPECIFIED UNSPECIFIED UNSPECIFIED Verma, Atul UNSPECIFIED UNSPECIFIED UNSPECIFIED Weerasooriya, Rukshen UNSPECIFIED UNSPECIFIED UNSPECIFIED Novak, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Arentz, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Deisenhofer, Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Rostock, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Rivard, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Guerra, Peter G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dyrda, Katia UNSPECIFIED UNSPECIFIED UNSPECIFIED Mondesert, Blandine UNSPECIFIED UNSPECIFIED UNSPECIFIED Dubuc, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Thibault, Bernard UNSPECIFIED UNSPECIFIED UNSPECIFIED Talajic, Mario UNSPECIFIED orcid.org/0000-0001-8469-4748 UNSPECIFIED Roy, Denis UNSPECIFIED UNSPECIFIED UNSPECIFIED Nattel, Stanley UNSPECIFIED orcid.org/0000-0002-5565-3311 UNSPECIFIED Macle, Laurent UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-267675
DOI:	10.1161/CIRCEP.115.003909
Journal or Publication Title:	Circ.-Arrhythmia Electrophysiol.
Volume:	9
Number:	8
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1941-3084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EARLY RECURRENCES; EUROPEAN-SOCIETY; ANTRUM ISOLATION; DELAYED CURE; PREDICTORS; TACHYARRHYTHMIAS; ASSOCIATION; MULTICENTER; ANTAGONIST; MANAGEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26767