Key result
Preprocedural atrial extrasystole frequency is not associated with AF recurrence after pulmonary vein isolation.
Why the study?
The predictive value of preprocedural atrial extrasystole frequency for atrial fibrillation recurrence after pulmonary vein isolation was unknown.
Does preprocedural atrial extrasystole frequency or AF during the blanking period predict AF recurrence in patients undergoing first-time PVI?
Cohort (n=684)
Does preprocedural atrial extrasystole frequency or AF during the blanking period predict AF recurrence in patients undergoing first-time PVI?
Preprocedural atrial extrasystole frequency does not predict AF recurrence after PVI, but AF occurring during the 90-day blanking period is a strong predictor of later recurrence.
Answers are grounded in this paper and cite their sources.
Preprocedural atrial extrasystole frequency should not guide post-PVI risk stratification; leaves open blanking-period AF as recurrence predictor.
Background Postprocedural atrial extrasystole (AES) frequency predicts atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) in patients with paroxysmal AF. However, the predictive value of preprocedural AES frequency is unknown. We investigate whether preprocedural AES frequency is a feasible marker to predict (timing of) AF recurrence after PVI. Methods Patients (N = 684) with paroxysmal or persistent AF undergoing first‐time PVI were evaluated for (a) the frequency of AES/day on Holter recordings without AF prior to PVI, (b) AF episodes during the 90 days blanking period, and (c) AF recurrences afterward. The correlation between AES/day and both development and timing of AF recurrences was tested. Results Preprocedural AES/day was similar in patients with paroxysmal (66 [20‐295] AES/day) and persistent AF (115 [12‐248] AES/day, P = .915). During the blanking period, 302 (44.2%) patients showed AF episodes. AF recurred in 379 (55.4%) patients at 203 (105‐400) days after PVI. AF recurred more frequently in patients with persistent (N = 104 [69.3%]) than in patients with paroxysmal AF (N = 275 [51.5%], P < .001). Frequency of AES prior to PVI was not correlated with development (P = .203) or timing (P = .478) of AF recurrences. AF recurrences occurred both more frequently (P < .001) and earlier (P < .000) in patients with AF during the blanking period. Conclusion AES/day prior to PVI is not correlated with (timing of) AF during the blanking period or AF recurrences, and is therefore not a feasible marker for AF recurrences in patients with PAF. AF during the blanking period is correlated with AF recurrence.
No takes yet. Share an insight, caveat, or question.
Lanters et al. (2020) conducted a cohort in Paroxysmal or persistent atrial fibrillation (n=684). Preprocedural atrial extrasystole (AES) frequency was evaluated on Development and timing of AF recurrences (p=0.203). Preprocedural atrial extrasystole frequency was not correlated with the development (P=0.203) or timing (P=0.478) of atrial fibrillation recurrences after pulmonary vein isolation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: