Abstract:
BACKGROUND:Recurrences are common within the first months following atrial fibrillation (AF) ablation. However, prior studies using only intermittent ECG recording have not shown a powerful correlation with ultimate response. OBJECTIVE:The purpose of this study was to use continuous AF monitoring with an implanted monitor to assess the AF burden measured continuously during the first months postablation and the relationship to subsequent AF recurrences. METHODS:Six hundred thirteen patients with symptomatic drug-refractory AF (17% with persistent AF) were part of this retrospective analysis. All patients underwent circumferential pulmonary vein isolation and were implanted with a subcutaneous AF monitor (Reveal XT, Medtronic) for collecting data on AF burden (AF%) during a 12-month follow-up period. AF freedom (responders) was defined as AF% ≤0.5% during each monthly telemetric follow-up. A receiver operating characteristic curve analysis was performed to identify the value in AF% during the first months in the postablation blanking period that was predictive of later recurrence of AF. Sensitivity of 90% was selected as the target value. RESULTS:After the first ablation procedure, 396 of the 613 patients (65%) were responders (AF ≤0.5%) at 12 months: 346 of 508 (68%) in the paroxysmal AF group and 50 of 105 (47%) in the persistent AF group. Using the receiver operating characteristic curve, the specificity corresponding to 90% sensitivity was 85% for AF% at 2 months. The corresponding threshold in the AF burden during the blanking period able to identify patients at risk for late recurrences was 4.5%, corresponding to a cumulative 65.9 hours (2.75 days) spent in AF during the first 2 months. In a multivariate analysis, AF% <4.5% during the first 2 months was highly significant (P <.001), and the odds ratio of responders/nonresponders was 39.8 (95% CI, 19.1-82.9). CONCLUSION:The AF burden measured during the blanking period can predict the response to catheter ablation at 12 months. AF% ≥4.5% at 2 months assessed by continuous monitoring is a powerful predictor of subsequent AF recurrences after initial ablation, thus providing relevant clinical information to select patients for early reintervention.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Pokushalov E,Romanov A,Corbucci G,Bairamova S,Losik D,Turov A,Shirokova N,Karaskov A,Mittal S,Steinberg JSdoi
10.1016/j.hrthm.2012.03.047subject
Has Abstractpub_date
2012-09-01 00:00:00pages
1375-9issue
9eissn
1547-5271issn
1556-3871pii
S1547-5271(12)00290-1journal_volume
9pub_type
杂志文章相关文献
HEART RHYTHM文献大全abstract:BACKGROUND:Pulmonary vein (PV) stenosis is an important potential complication of PV isolation using thermal modalities such as radiofrequency ablation (RFA). Pulsed field ablation (PFA) is an alternative energy that causes nonthermal myocardial cell death. OBJECTIVE:The purpose of this study was to compare the effect...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.04.040
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Specific 12-lead ECG criteria have been reported to predict an epicardial site of origin (SoO) of induced ventricular tachycardias (VTs) in left ventricular nonischemic cardiomyopathy. OBJECTIVE:The purpose of this study was to (1) determine the value of ECG criteria to predict an epicardial SoO of clinical...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.03.001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Little is known about the tachyarrhythmias relating to respiration. Case reports presented patients with respiratory cycle-dependent atrial tachycardias (RCATs), which cyclically emerge after starting inspiration and cease during expiration. OBJECTIVE:The aim of the present study was to elucidate the preval...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.04.031
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The pulmonary veins (PVs) and the PV-LA (left atrium) junction are established sources of triggers initiating atrial fibrillation. In addition, they have been implicated in the maintenance of arrhythmia. OBJECTIVE:To undertake high-density electrophysiological characterization of the right superior PV-LA ju...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.09.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:We examined nonprescription weight-loss supplements marketed on the Internet for ingredients with potential arrhythmogenic and life-threatening cardiac adverse effects. OBJECTIVE:We aimed to define the risks of life-threatening cardiac adverse effects that are associated with weight-loss supplements markete...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.02.021
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. OBJECTIVE:We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials th...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2015.05.010
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). OBJECTIVE:The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS an...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2019.07.003
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Little is known about the exact boundaries of the reentrant circuit in the slow-slow form of atrioventricular nodal reentrant tachycardia (AVNRT). OBJECTIVE:The purpose of this study was to examine the tachycardia circuit in the slow-slow form of AVNRT. METHODS:Single extrastimuli were delivered during the...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.02.010
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) scanning of magnetic resonance (MR)-conditional cardiac implantable cardioverter-defibrillators (ICDs) can be performed safely following specific protocols. MRI safety with cardiac resynchronization therapy-defibrillators (CRT-Ds) incorporating quadripolar left ventricular (L...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.08.020
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:An accurate estimate of the incidence of sudden cardiac arrest (SCA) in high school student athletes is needed to guide prevention strategies. OBJECTIVE:To prospectively investigate SCA rates in high school student athletes vs student nonathletes. METHODS:A prospective observational study of 2149 US high s...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.04.017
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Complete circumferential antral ablation may not be necessary for successful pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). OBJECTIVE:We examined the feasibility of a noncircumferential approach limited to segments of the antra required for PV-atrial conduction. METHODS...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.09.069
更新日期:2011-01-01 00:00:00
abstract::Newer generations of pacemakers and implantable cardioverter defibrillators have enhanced diagnostic features that permit detection and storage of information about the frequency, duration, time of onset, and rate characteristics of multiple consecutive episodes of atrial tachycardia and atrial fibrillation (AF). Para...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2004.03.075
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Mapping and ablation of atrial macroreentrant tachycardia focus on activation mapping with identification of the area of slow conduction. OBJECTIVE:The purpose of this study was to evaluate a new concept for analysis and treatment of macroreentrant tachycardia based on color-coded three-dimensional (3D) ent...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.12.013
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The AdaptivCRT algorithm (aCRT) automatically adjusts atrioventricular delays each minute to achieve ventricular fusion through left ventricular (LV) or biventricular (BiV) pacing. aCRT is associated with superior clinical outcomes compared to standard BiV pacing, but the association of aCRT and subsequent a...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.05.012
更新日期:2019-07-01 00:00:00
abstract::Antitachycardia pacing (ATP) strategies represent safe, effective, and painless therapy for ventricular tachyarrhythmias, with a large body of clinical evidence supporting their routine use in both primary and secondary implantable cardioverter-defibrillator recipients. This article details the evidence supporting the...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.02.024
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) has been performed safely in patients without MRI-conditional cardiac implantable electronic devices (CIEDs), but experience specifically with cardiac magnetic resonance imaging (CMR) is limited in this patient population. OBJECTIVE:Evaluate the safety of CMR in non-MRI-cond...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2017.10.003
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) often progresses to more sustained forms and increases the risk of ischemic stroke or sinus node dysfunction. However, there have been no data on the clinical outcomes of patients who developed AF during head-up tilt testing (HUT). OBJECTIVE:The purpose of this study was to evaluate...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.11.030
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Pacing in the right ventricle can cause a variety of detrimental effects, including atrial tachyarrhythmias (atrial tachycardia [AT]/atrial fibrillation [AF]). OBJECTIVE:The purpose of this study was to evaluate the incidence and predictors of persistent AT/AF in patients with long-term exposure to ventricu...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2015.06.041
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the surface electrocardiogram (ECG) morphology of common atrial tachycardias (ATs) that occur after pulmonary vein (PV) isolation. BACKGROUND:Focal ATs from reconnected PVs and macroreentrant mitral annular (MA) flutter are the most common form of ATs occurring after...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.05.008
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Asymptomatic cerebral embolus (ACE) detected by diffusion-weighted magnetic resonance imaging (DW-MRI) following atrial fibrillation (AF) ablation has been reported at varying rates with different ablation techniques. OBJECTIVE:To evaluate the incidence of ACE after phased radiofrequency ablation for AF wit...
journal_title:Heart rhythm
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.hrthm.2013.04.005
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Ablation of ventricular tachycardia and premature ventricular contraction arising at the aortic root has been described. The use of radiofrequency ablation energy has been associated with life-threatening collateral damage. The use of cryoablation as a safer alternative energy source at the aortic root has n...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.10.008
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:New approaches to ablation of atrial fibrillation (AF) include focal impulse and rotor modulation (FIRM). Studies of this technology with short-term follow-up have shown favorable outcomes. OBJECTIVE:The purpose of this study was to characterize the long-term results of FIRM ablation in a cohort of patients...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2015.10.031
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Endocardial mapping tools use variable interelectrode resolution, whereas body surface mapping tools use narrow bandpass filtering (BPF) to map fibrillatory mechanisms established by high-resolution optical imaging. OBJECTIVE:The purpose of this study was to study the effect of resolution and BPF on the und...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2017.01.023
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Frequent premature ventricular complexes (PVCs) are common after a myocardial infarction (MI), but data on PVC ablation in this population are limited. OBJECTIVE:The purpose of this study was to analyze data on PVC ablation in post-MI patients. METHODS:Three hundred thirty-two patients with frequent PVCs a...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.07.037
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Ablation of the aortic sinus of Valsalva in adults for ectopic atrial tachycardia (EAT) and ventricular tachycardia (VT)/premature ventricular complexes (PVCs) has been reported in only a very few patients. Limited data exist concerning the safety of aortic ablation. OBJECTIVE:The purpose of this study was ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.06.010
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:With the increasing use of implantable cardioverter-defibrillators (ICDs), device complications are becoming more common. Fungal-related ICD infections have rarely been reported, and little is known about the presentation, prevalence, and treatment options for these morbid infections. OBJECTIVES:The purpose...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.04.012
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Pulmonary vein isolation (PVI) is commonly performed in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (PAF). However, the very long-term follow-up result is limited. OBJECTIVE:We aimed to investigate 10-year ablation outcomes in patients with PAF and long-term follow-up results af...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.03.028
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) requires a high percentage of ventricular pacing (%Vp) to maximize its clinical benefits. Atrial fibrillation (AF) has been shown to reduce %Vp in CRT due to competition with irregular intrinsic atrioventricular (AV) conduction. We report the results of a prospective r...
journal_title:Heart rhythm
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.hrthm.2017.10.026
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Ranolazine exhibits a synergistic effect in combination with class III drugs to suppress atrial fibrillation. OBJECTIVE:To investigate whether a combination therapy affects repolarization and provokes ventricular tachyarrhythmias (VT) in a sensitive model of proarrhythmia. METHODS:Thirty-seven rabbits were...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.08.029
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:To evaluate the feasibility and outcome of ablation to transect the anterior left atrium (LA) in patients with atrial fibrillation (AF). BACKGROUND:While the Maze procedure is effective in maintaining sinus rhythm in patients with AF, it is associated with significant morbidity. This prospective clinical st...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.03.072
更新日期:2004-07-01 00:00:00