Key result
Frequent premature atrial contractions detected by Holter monitoring 6 months after catheter ablation independently predicted late recurrence of atrial fibrillation (HR 1.93).
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Careful long-term follow-up with appropriate monitoring methods is essential after successful catheter ablation of AF to detect recurrence and guide anticoagulation therapy.
patients with dramatic improvement of AF-related symptoms, such as palpitation, chest discomfort and dyspnea, after catheter ablation, it does not always indicate the absence of recurrence of AF.The duration of AF might be shorter and the AF incidence might be lower, even if AF recurred after catheter ablation.We should always keep in mind that "negative proof is NOT proof of negative" in the clinical examination.Careful close follow-up by appropriate monitoring methods is needed even after successful catheter ablation of AF.Anticoagulation therapy for 3 weeks before the AF procedure and its continuation for at least for 3 months after the procedure is essential to prevent periprocedural complications.5 Anticoagulation therapy should be continued as long as possible for patients at high risk of thromboembolism or stroke.On the other hand, discontinuation of anticoagulation therapy might be considered in the absence of AF recurrence and prior history of stroke, transient
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Iwasaki et al. (2020) conducted an editorial in Atrial fibrillation. Frequent premature atrial contractions (PACs) vs. Infrequent or no PACs was evaluated on Late recurrence of atrial fibrillation (HR 1.93, 95% CI 1.24-3.02, p=<0.01). Frequent premature atrial contractions detected by Holter monitoring 6 months after catheter ablation independently predicted late recurrence of atrial fibrillation (HR 1.93).
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