New Predictor of Very Late Recurrence After Catheter Ablation of Atrial Fibrillation Using Holter Electrocardiogram Parameters
Section snippets
Methods
We retrospectively studied consecutive symptomatic AF patients who underwent a first CA between January 2011 and Mach 2017 and underwent 24-hour Holter ECGs 12 months after the CA. The exclusion criteria for this study were patients in need of antiarrhythmic drugs more than 3 months after the CA and those with recurrence of AF or atrial tachycardia within 12 months except for during the blanking period (3 months). All patients underwent CA at Osaka Rosai Hospital, according to the current
Results
Of 484 consecutive patients, 231 patients were excluded from this study due to a lost follow up, relapsed AF and requiring antiarrhythmic drugs. We retrospectively studied 253 consecutive symptomatic AF patients (age 66 ± 9 years, woman: 30%, paroxysmal AF: 73%). During a mean follow up duration of 46 ± 18 months, VLRAF occurred in 51 patients (20%) (VLRAF group). In 51 relapsed AF episodes, 90% had an AF burden >6 minutes, 70% had an AF burden >6 hours, and 40% had an AF burden ≥24 hours. The
Discussion
This study has elucidated the predictors of VLRAF in patients without antiarrhythmic drugs after the initial CA, using the parameters automatically calculated by the analysis software of the 24-hour Holter ECG. The main findings of this study were as follows: (1) ERAF, APCs burden of ≥0.159%, and minimum prematurity index of the APCs of ≤48% were associated with VLRAF; (2) in particular, a prematurity index of the APCs of ≤48% was an independent risk factor for VLRAF.
Yamane et al8 investigated
Author Contributions
All authors substantially contributed to the work and met the authorship criteria as follows:
Conception and design or analysis and interpretation of the data: Yasuyuki Egami, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro and Koji Yasumoto. Drafting of the manuscript or revising it critically for its important intellectual content: Masaki Tsuda, Naotaka Okamoto, Akihiro Tanaka, Yasuharu Matsunaga-Lee, Masamichi Yano and Ryu Shutta. Final approval of the manuscript submitted:
Disclosures
The authors have no conflicts of interest to disclose.
Acknowledgment
The authors thank Mr. John Martin for his linguistic assistance with this manuscript.
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