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Symptomatic and Asymptomatic Long‐Term Recurrences Following Transcatheter Atrial Fibrillation Ablation
Author(s) -
MANGANIELLO SABRINA,
ANSELMINO MATTEO,
AMELLONE CLAUDIA,
PELISSERO ELISA,
GIUGGIA MARCO,
TRAPANI GIUSEPPE,
GIORDANO BENEDETTA,
SENATORE GAETANO,
GAITA FIORENZO
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12387
Subject(s) - medicine , asymptomatic , atrial fibrillation , ablation , cardiology , pulmonary vein , catheter ablation , incidence (geometry) , univariate analysis , surgery , multivariate analysis , physics , optics
Background Atrial fibrillation (AF) relapses, following transcatheter AF ablation, are frequently reported based on patients’ symptoms, scheduled electrocardiograms (ECGs), or 24‐hour Holter recordings. The aim of this study is to determine the incidence of asymptomatic and symptomatic AF recurrences, using continuous subcutaneous ECG monitoring, in the long‐term follow‐up of patients with paroxysmal or persistent AF undergoing transcatheter ablation. Methods and Results In total 113 consecutive patients symptomatic for paroxysmal or persistent AF were enrolled. All patients underwent pulmonary vein isolation plus left linear lesions. The insertable cardiac monitor (ICM), subcutaneously implanted during the ablation procedure, recorded the amount of AF per day (daily burden) and per last follow‐up period (total AF burden). Based on symptoms and on scheduled 12‐lead ECG performed during follow‐up, 40 patients (35.4%) suffered AF recurrences. By means of ICM data, however, arrhythmia relapses were recorded within 75 patients (66.3%), of whom 35 (46.7%) were asymptomatic. Patients suffering symptomatic AF recurrences resulted, at univariate analysis, older (66.6 ± 8.4 years vs 61.6 ± 10.7 years) and suffering greater AF burden (88.8 ± 26.9% vs 8.0 ± 8.0%). Conclusions AF ablation outcome based on patients’ symptoms and/or scheduled ECGs underestimated relapses, as up to half of the patients, during a long‐term follow‐up, suffer asymptomatic recurrences.