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Dissociated Pulmonary Vein Activity After Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation: A Predictor for Recurrence?
Author(s) -
BUIATTI ALESSANDRA,
AMMAR SONIA,
REENTS TILKO,
SEMMLER VERENA,
KATHAN SUSANNE,
HOFMANN MONIKA,
BOURIER FELIX,
TELISHEVSKA MARTHA,
KOCHBÜTTNER KATHARINA,
KAESS BERNHARD,
LENNERZ CARSTEN,
KOLB CHRISTOF,
HESSLING GABRIELE,
DEISENHOFER ISABEL
Publication year - 2015
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12507
Subject(s) - medicine , pulmonary vein , atrial fibrillation , paroxysmal atrial fibrillation , cardiology , catheter ablation , ablation
Dissociated Pulmonary Vein Activity for Paroxysmal Atrial Fibrillation Background The role of dissociated pulmonary vein (DPV) activity after pulmonary vein isolation (PVI) is still poorly defined. We evaluated electrophysiological features and clinical impact on long‐term outcome of DPV activity. Methods A total of 243 patients (mean age 63 ± 11 years; 63% males) undergoing PVI for paroxysmal atrial fibrillation (AF) were included. DPV activity was defined as a residual low frequency irregular PV rhythm. Patients were divided into Group 1 (presence of DPV activity; n = 65) or Group 2 (absence of DPV activity; n = 178). Results Of 936 isolated PVs, 112 PVs (12%) showed DPV activity. DPV activity was observed more frequently in PVs identified as AF triggers (P = 0.026). During follow‐up (mean 12 ± 7 months), 15 of 65 patients of Group 1 (23%) and 57 of 178 patients of Group 2 (32%) had an arrhythmia recurrence (P = 0.23). At linear regression analysis, no independent predictor for clinical recurrence was identified. During the repeat ablation, 62 of 72 patients (86%) showed a recovered PV conduction without difference between the 2 groups. Clinically, all patients of Group 1 with PV reconnection (n = 13/15) had a recurrence of paroxysmal AF. In Group 2, 5 of 52 patients with reconnected PV developed non‐PV related arrhythmias. Conclusion DPV activity occurred in 12% of PVs after PVI and was observed more frequently in PVs identified as AF triggers. DPV activity was not predictive for AF recurrence during follow‐up. PV‐left atrium reconnection involving PVs with DPV activity leads to AF.