Clinical predictors of arrhythmia recurrences following pulmonary vein antrum isolation for atrial fibrillation: predicting arrhythmia recurrence post-PVAI.
J Cardiovasc Electrophysiol
; 22(11): 1206-14, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-21668562
ABSTRACT
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 ANDRESULTS:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
/
Fibrilação Atrial
/
Ablação por Cateter
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article