Key result
Minimal or mild pericardial effusion after pulmonary vein isolation for paroxysmal atrial fibrillation had no significant association with late arrhythmic recurrence (36.7% vs 35.1%; P=0.988).
Why the study?
The clinical implications of pericardial effusion after catheter ablation for AF are not well understood.
Does newly developed pericardial effusion after pulmonary vein isolation predict arrhythmic recurrence in patients with paroxysmal atrial fibrillation?
Cohort (n=184)
Does newly developed pericardial effusion after pulmonary vein isolation predict arrhythmic recurrence in patients with paroxysmal atrial fibrillation?
Absolute Event Rate: 36.7% vs 35.1%
p-value: p=0.988
Minimal or mild pericardial effusion is a frequent finding after PVI for paroxysmal AF but is not associated with arrhythmic recurrence, suggesting routine post-ablation TTE may lack clinical utility.
Minimal or mild post-PVI effusion shows no link to recurrence; leaves open the utility of routine post-ablation TTE in paroxysmal AF.
BACKGROUND: The clinical implications of pericardial effusion (PE) after catheter ablation for atrial fibrillation (AF) are not well understood. We evaluated the association between newly developed PE after pulmonary vein isolation (PVI) for paroxysmal AF and arrhythmic recurrence. METHODS: From a prospective AF ablation registry, 184 patients (mean age 59 ± 10 years, 65% male) who underwent first-time PV isolation using a smart touch surround flow catheter (Biosense Webster, Diamond Bar, CA) were analyzed. Postablation transthoracic echocardiography (TTE) was performed within 1-3 days after ablation, and the occurrence of PE was assessed. RESULTS: PE developed in 91 patients (49.5%), and most were of minimal severity (minimal, 93.4%; mild, 6.6%). Patients with PE had significantly lower body mass index and underwent cavotricuspid isthmus ablation more frequently. Early arrhythmic recurrence (EAR) (within 3 months) was observed in 28.8% of patients and was not different according to the PE development (PE [+]: 29.7% vs PE [-]: 28.0%; P = .80). During a median follow-up of 696 days, the cumulative rate of the late arrhythmic recurrence (LAR) (after 3 months) was 36.4%, and there was no difference between groups (PE [+]: 36.7% vs PE [-]: 35.1%; P = .988). The only predictor of LAR was EAR, and no echocardiographic parameters showed a significant correlation with LAR. CONCLUSIONS: Minimal or mild PE after PVI for paroxysmal AF is a frequent echocardiographic finding, and it had no significant association with AF recurrence. Routine TTE after AF ablation has no clinical implication.
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Do et al. (2020) conducted a cohort in paroxysmal atrial fibrillation (n=184). Newly developed pericardial effusion vs. No pericardial effusion was evaluated on Late arrhythmic recurrence (after 3 months) (p=0.988). Minimal or mild pericardial effusion after pulmonary vein isolation for paroxysmal atrial fibrillation had no significant association with late arrhythmic recurrence (36.7% vs 35.1%; P=0.988).
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