Document Detail


Value of different follow-up strategies to assess the efficacy of circumferential pulmonary vein ablation for the curative treatment of atrial fibrillation.
MedLine Citation:
PMID:  16403058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The objective of this study was to compare transtelephonic ECG every 2 days and serial 7-day Holter as two methods of follow-up after atrial fibrillation (AF) catheter ablation for the judgment of ablation success. Patients with highly symptomatic AF are increasingly treated with catheter ablation. Several methods of follow-up have been described, and judgment on ablation success often relies on patients' symptoms. However, the optimal follow-up strategy objectively detecting most of the AF recurrences is yet unclear. METHODS: Thirty patients with highly symptomatic AF were selected for circumferential pulmonary vein ablation. During follow-up, a transtelephonic ECG was transmitted once every 2 days for half a year. Additionally, a 7-day Holter was recorded preablation, after ablation, after 3 and 6 months, respectively. With both, procedures symptoms and actual rhythm were correlated thoroughly. RESULTS: A total of 2,600 transtelephonic ECGs were collected with 216 of them showing AF. 25% of those episodes were asymptomatic. On a Kaplan-Meier analysis 45% of the patients with paroxysmal AF were still in continuous SR after 6 months. Simulating a follow-up based on symptomatic recurrences only, that number would have increased to 70%. Using serial 7-day ECG, 113 Holter with over 18,900 hours of ECG recording were acquired. After 6 months the percentage of patients classified as free from AF was 50%. Of the patients with recurrences, 30-40% were completely asymptomatic. The percentage of asymptomatic AF episodes stepwise increased from 11% prior ablation to 53% 6 months after. CONCLUSIONS: The success rate in terms of freedom from AF was 70% on a symptom-only-based follow-up; using serial 7-day Holter it decreased to 50% and on transtelephonic monitoring to 45%, respectively. Transtelephonic ECG and serial 7-day Holter were equally effective to objectively determine long-term success and to detect asymptomatic patients.
Authors:
Christopher Piorkowski; Hans Kottkamp; Hildegard Tanner; Richard Kobza; Jens Cosedis Nielsen; Arash Arya; Gerhard Hindricks
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  16     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-11     Completed Date:  2006-03-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1286-92     Citation Subset:  IM    
Affiliation:
University of Leipzig, Heart Center, Department of Electrophysiology Strümpellstrasse, Leipzig, Germany. CP7026@yahoo.de
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / physiopathology,  therapy*
Catheter Ablation*
Clinical Trials as Topic
Electrocardiography
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Germany
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Veins*
Telemetry
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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