Open AccessRecurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto‐trigger function
Author(s) -
Kawasaki Shiro,
Tanno Kaoru,
Ochi Akinori,
Inokuchi Koichiro,
Chiba Yuta,
Onishi Yoshimi,
Onuma Yoshimasa,
Munetsugu Yumi,
Kikuchi Miwa,
Ito Hiroyuki,
Onuki Tatsuya,
Miyoshi Fumito,
Minoura Yoshino,
Watanabe Norikazu,
Adachi Taro,
Asano Taku,
Kobayashi Youichi
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2014.08.002
Subject(s) - medicine , atrial fibrillation , pulmonary vein , cardiology , paroxysmal atrial fibrillation , implantable loop recorder , catheter ablation , ablation , predictive value , surgery
Background Pulmonary vein isolation (PVI) via catheter ablation has been shown to be a highly effective treatment option for patients with symptomatic paroxysmal atrial fibrillation (AF). The recurrence of AF within 3 months after PVI is not considered to be the result of ablation procedure failure, because early recurrence of AF is not always associated with late recurrence. We examined the usefulness of an external loop recorder with an auto‐trigger function (ELR‐AUTO) for the detection of atrial fibrillation following PVI to characterize early recurrence and to determine the implications of AF occurrence within 3 months after PVI. Methods Fifty‐three consecutive symptomatic patients with paroxysmal AF (age 61.6±12.6 years, 77% male) who underwent PVI and were fitted with ELR‐AUTO for 7±2.0 days within 3 months after PVI were enrolled in this study. Results Of the 33 (62.2%) patients who did not have AF recurrence within 3 months after PVI, only 1 patient experienced AF recurrence at 12 months. Seven (35%) of the 20 patients who experienced AF within 3 months of PVI experienced symptomatic AF recurrence at 12 months. The sensitivity, specificity, positive predictive value, and negative predictive value of early AF recurrence for late recurrence were 87.5%, 71.1%, 35.0%, and 96.9%, respectively. Conclusions AF recurrence measured by ELR‐AUTO within 3 months after PVI can predict the late recurrence of AF. Freedom from AF in the first 3 months following ablation significantly predicts long‐term AF freedom. ELR‐AUTO is useful for the detection of symptomatic and asymptomatic AF.