Dataset Information

Predictive value of the induction test with atrial burst pacing with regard to long-term recurrence after ablation in persistent atrial fibrillation.

ABSTRACT:

Background

Induction test of atrial fibrillation (AF) is one of endpoint measures in catheter ablation (CA). However, its predictive value in long-term outcome remains controversial.

Methods

Ninety-eight patients (61 years, 77 males) with persistent AF who underwent pulmonary vein antrum isolation-based CA were retrospectively analyzed. We determined whether inducibility of AF/atrial tachyarrhythmias (AT) by atrial burst pacing at the end of CA and other characteristics were associated with the recurrence of AF/AT. Atrial burst pacing was performed with 30-beat from the coronary sinus; increasing from 240 to 320 ppm. Inducibility was defined as AF/AT lasting ?5 minutes following atrial burst pacing.

Results

AF/AT was induced in 50 patients (51%). During 1 year of follow-up, 71 patients (72.4%) had no recurrence of AF/AT. A logistic regression analysis showed that female gender (OR 3.8; P = 0.02), multiple sessions (OR 3.5; P = 0.02), and early recurrence of AF/AT (OR 5.3; P = 0.004) were associated with clinical recurrence. AF/AT Inducibility was not associated with clinical recurrence (P = 0.65). A subanalysis in patients with enlarged LA (LA diameter ?45 mm, n = 40) showed that AF/AT inducibility was associated with recurrence (OR 8.1; P = 0.04). The positive and negative predictive values of AF/AT inducibility for AF/AT recurrence were 41 and 89%, respectively. Negative predictive value was increased to 92.3% when the inducibility was defined as AF/AT of ?30 seconds following atrial burst pacing.

Conclusions

AF/AT inducibility cannot predict long-term clinical recurrence in patients with persistent AF. However, it may have a prognostic value especially in patients with enlarged LA.

SUBMITTER: Kawai S

PROVIDER: S-EPMC6457478 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Predictive value of the induction test with atrial burst pacing with regard to long-term recurrence after ablation in persistent atrial fibrillation.

Kawai Shunsuke S Mukai Yasushi Y Inoue Shujiro S Yakabe Daisuke D Nagaoka Kazuhiro K Sakamoto Kazuo K Takase Susumu S Chishaki Akiko A Tsutsui Hiroyuki H

Journal of arrhythmia 20190118 2

<h4>Background</h4>Induction test of atrial fibrillation (AF) is one of endpoint measures in catheter ablation (CA). However, its predictive value in long-term outcome remains controversial.<h4>Methods</h4>Ninety-eight patients (61 years, 77 males) with persistent AF who underwent pulmonary vein antrum isolation-based CA were retrospectively analyzed. We determined whether inducibility of AF/atrial tachyarrhythmias (AT) by atrial burst pacing at the end of CA and other characteristics were assoc ...[more]

PMID: 31007786

Similar Datasets

Project description:BackgroundLeft atrial (LA) function following catheter or surgical ablation of de-novo long-standing persistent atrial fibrillation (AF) and its impact on AF recurrence was studied in patients participating in the CASA-AF trial (Catheter Ablation vs. Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation).MethodsAll patients underwent echocardiography preablation, 3 and 12 months post-ablation. LA structure and function were assessed by 2-dimensional volume and speckle tracking strain measurements of LA reservoir, conduit, and contractile strain. Left ventricular diastolic function was measured using transmitral Doppler filling velocities and myocardial tissue Doppler velocities to derive the e', E/e', and E/A ratios. Continuous rhythm monitoring was achieved using an implantable loop recorder.ResultsEighty-three patients had echocardiographic data suitable for analysis. Their mean age was 63.6±9.7 years, 73.5% were male, had AF for 22.8±11.6 months, and had a mean LA maximum volume of 48.8±13.8 mL/m2. Thirty patients maintained sinus rhythm, and 53 developed AF recurrence. Ablation led to similar reductions in LA volumes at follow-up in both rhythm groups. However, higher LA emptying fraction (36.3±10.6% versus 27.9±9.9%; P<0.001), reservoir strain (22.6±8.5% versus 16.7±5.7%; P=0.001), and contractile strain (9.2±3.4% versus 5.6±2.5%; P<0.001) were noted in the sinus rhythm compared with AF recurrence group following ablation at 3 months. Diastolic function was better in the sinus rhythm compared with the AF recurrence group with an E/A ratio of 1.5±0.5 versus 2.2±1.2 (P<0.001) and left ventricular E/e' ratio of 8.0±2.1 versus 10.3±4.1 (P<0.001), respectively. LA contractile strain at 3 months was the only independent predictor of AF recurrence.ConclusionsFollowing ablation for long-standing persistent AF, improvement in LA function was greater in those who maintained sinus rhythm. LA contractile strain at 3 months was the most important determinant of AF recurrence following ablation.RegistrationURL: https://www.Clinicaltrialsgov; Unique identifier: NCT02755688.

Dataset Information

Predictive value of the induction test with atrial burst pacing with regard to long-term recurrence after ablation in persistent atrial fibrillation.

Background

Methods

Results

Conclusions

Publications

Predictive value of the induction test with atrial burst pacing with regard to long-term recurrence after ablation in persistent atrial fibrillation.

Similar Datasets

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