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Clinical Predictors of Arrhythmia Recurrences Following Pulmonary Vein Antrum Isolation for Atrial Fibrillation: Predicting Arrhythmia Recurrence Post-PVAI.
MedLine Citation:
PMID:  21668562     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Predicting Arrhythmia Recurrence Post-PVAI. Introduction: Pulmonary vein antrum isolation (PVAI) is an accepted treatment for atrial fibrillation (AF) refractory to medical therapy. The purpose of this study was to identify the patient, procedural, and follow-up factors associated with arrhythmia recurrences following PVAI. Methods and Results: Clinical data were prospectively collected on all 385 consecutive patients who had 530 PVAI (age 58 ± 11 years, 63% paroxysmal AF-PAF, follow-up 2.8 ± 1.2 years) between February 2004 and March 2009. ECGs were recorded at each follow-up visit with Holter monitoring 1, 3, 6, and 12 months following PVAI and every 6 months thereafter. Recurrences < 3 months post-PVAI were defined as early, 3 months-1 year post-PVAI as late, and > 1 year post-PVAI as very late. Relationship between predictor variables and outcomes was modeled using Cox proportional hazards analysis. Late recurrences occurred in 42% with a lower rate among PAF versus non-PAF patients (39% vs 56%, P = 0.001). Of the 256 patients with ≥ 1-year follow-up, 121 (47%) had no arrhythmia off antiarrhythmic drugs (AADs) 1 year post-PVAI; 36 (30%) of these had a very late recurrence. In multivariate analysis, non-PAF, hypertension, and prior AAD failure predicted recurrence. When entered into the model, early recurrences remained the only predictor of late recurrences. Conclusion: Patients with non-PAF, hypertension, and prior failure of multiple AAD were more likely to experience arrhythmia recurrence post-PVAI. Early recurrences were the strongest predictor of late recurrences. Late and very late recurrences following PVAI were common and should be considered when planning long-term AF patient management. (J Cardiovasc Electrophysiol, Vol. pp. 1-9).
Authors:
Yaariv Khaykin; Richard Oosthuizen; Lauren Zarnett; Vidal Essebag; Ratika Parkash; Catherine Seabrook; Marianne Beardsall; Bernice Tsang; Zaev Wulffhart; Atul Verma
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-10
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Southlake Regional Health Center, Newmarket, Ontario, Canada McGill University Health Center, Montreal, Quebec, Canada QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
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