Key result
The appearance of atrial fibrillation after 3 months predicted subsequent failure of pulmonary vein isolation with a positive predictive value of 87% and a negative predictive value of 90%.
Why the study?
Does the appearance of atrial fibrillation after 3 months predict true recurrence and procedural failure in patients who underwent pulmonary vein isolation?
Observational (n=79)
Does the appearance of atrial fibrillation after 3 months predict true recurrence and procedural failure in patients who underwent pulmonary vein isolation?
Waiting at least 3 months after pulmonary vein isolation is recommended before judging procedural failure, as early transient AF often resolves.
Background: It is sometimes difficult to differentiate the transient appearance of atrial fibrillation (AF) after pulmonary vein (PV) isolation from a true recurrence of AF. We attempted to differentiate them by analyzing the time course after the procedure. Methods and Results: 79 patients who underwent PV isolation were divided into two groups (successful: N = 60 and unsuccessful: N = 19) according to the final outcome. Antiarrhythmic drugs were used either temporarily or continuously to treat re-appearance of AF after the procedure. The transient appearance of AF in the successful group gradually faded, while true AF recurrence in the unsuccessful group consistently increased in line with the follow-up (F/U) period. The appearance of AF after 3 months predicted a subsequent failure of the procedure with a positive/negative predictive value of 87/90%, respectively. Conclusion: Since the transient appearance of AF decreased and the true recurrence of AF increased in line with the F/U period, we should therefore wait at least 3 months before judging the outcome of PV isolation.
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Inada et al. (2006) conducted an observational in Atrial fibrillation (n=79). Pulmonary vein isolation was evaluated on Prediction of subsequent failure of the procedure by appearance of AF after 3 months (PPV 87%, NPV 90%). The appearance of atrial fibrillation after 3 months predicted subsequent failure of pulmonary vein isolation with a positive predictive value of 87% and a negative predictive value of 90%.
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