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Early recurrences of atrial tachyarrhythmias post pulmonary vein isolation
Author(s) -
Olshausen Gesa,
Uijl Alicia,
JensenUrstad Mats,
Schwieler Jonas,
Drca Nikola,
Bastani Hamid,
Tapanainen Jari,
Saluveer Ott,
Bourke Tara,
Kennebäck Göran,
Insulander Per,
Deisenhofer Isabel,
Braunschweig Frieder
Publication year - 2020
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.14368
Subject(s) - medicine , pulmonary vein , atrial fibrillation , cardiology , paroxysmal atrial fibrillation
Abstract Aims To investigate the significance of early recurrence (ER) of atrial tachyarrhythmias after pulmonary vein isolation (PVI) on the development of late recurrence (LR) and to redefine the blanking period during which an ER is considered nonspecific. Methods Data of 713 patients undergoing their first PVI for paroxysmal or persistent atrial fibrillation between January 2012 and December 2017 were included. All patients were followed‐up for 12 months according to clinical and outpatient routine and were screened for any atrial tachyarrhythmia lasting >30 seconds occurring during the first 3 months postablation (ER) and after the 3 months blanking period (LR). Results Patients with ER compared to those without ER had significantly more LR (74.5% vs 16.5% vs, P < .001). The occurrence of ER during the first, second and third months showed increasing LR rates of 35.2%, 67.9%, and 94.8%, respectively ( P < .001). Receiver operator characteristic analysis revealed a blanking period of 46 days with the highest sensitivity (68.1%) and specificity (96.5%). Later timing and longer time span of ER were independent predictors for LR in multivariable analysis. Conclusion ER is a strong predictor for LR. Our study advocates a shortening of the post‐PVI blanking period followed by a “gray zone” up to 3 months where individualized therapeutic decisions based on additional risk factors should be considered. We suggest that the ER time span might serve as such a predictor identifying patients at the highest risk for LR.