Asymptomatic recurrences of atrial fibrillation after pulmonary vein isolation.
Thomas Neumann,Ali Erdogan,Thorsten Dill,Harald Greiss,Alexander Berkowitsch,Johannes Sperzel,Malte Kuniss,Klaus Kurzidim,Christian W. Hamm,H. F. Pitschner +9 more
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TLDR
Reliance on perception of AF by patients after PVI results in an underestimation of recurrence of the arrhythmia and the success of ablation is evaluated.Abstract:
Aims The purpose of this study was to determine the occurrence of asymptomatic episodes of atrial fibrillation (AF) and wrong AF perception after pulmonary vein isolation (PVI). We evaluated the success of ablation by using the following measurements: (i) clinical symptoms and duration of symptoms noticed by patients and (ii) synchronous event recording (ER). Methods and results Eighty patients with paroxysmal AF underwent PVI and were provided repeatedly with a portable ER upon discharge and every 3 months for a year. The ER automatically detects arrhythmias by a detection algorithm and can also be manually triggered by the patient. In 46/80 patients (57.5%), episodes of AF were documented. Asymptomatic AF was detected in 21.3%. In 9/80 patients (11.3%), who reported clinical AF recurrence, no AF could be shown by ER. We compared patients’ perception to have suffered AF episodes with the ERs and found a sensitivity of 75% and a specificity of 92%. Conclusion Reliance on perception of AF by patients after PVI results in an underestimation of recurrence of the arrhythmia. We observed a maximal occurrence of silent AF or wrong perception of AF in 26/80 (32.6%) patients.read more
Citations
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Venice Chart international consensus document on atrial fibrillation ablation.
Andrea Natale,Antonio Raviele,Thomas Arentz,Hugh Calkins,Shih-Ann Chen,Michel Haïssaguerre,Gerhard Hindricks,Yen Ho,Karl-Heinz Kuck,Francis Marchlinski,Carlo Napolitano,Douglas Packer,Carlo Pappone,Eric N. Prystowsky,Richard Schilling,Dipen Shah,Sakis Themistoclakis,Atul Verma +17 more
TL;DR: The Venice Chart International Consensus Document on Atrial Fibrillation Ablation is presented, highlighting the need to understand more fully the rationale behind atrial fibrillation ablation and its role in patients’ health.
Journal ArticleDOI
Discerning the incidence of symptomatic and asymptomatic episodes of atrial fibrillation before and after catheter ablation (DISCERN AF): a prospective, multicenter study.
Atul Verma,Jean Champagne,John L. Sapp,Vidal Essebag,Paul Novak,Allan C. Skanes,Carlos A. Morillo,Yaariv Khaykin,David H. Birnie +8 more
TL;DR: The DISCERN AF study as mentioned in this paper monitored atrial fibrillation (AF) using an implantable cardiac monitor (ICM) to assess the incidence and predictors of asymptomatic AF before and after catheter ablation.
Discerning the Incidence of Symptomatic and Asymptomatic Episodes of Atrial Fibrillation Before and After Catheter Ablation (DISCERN AF)
Jean Champagne,John L. Sapp,Vidal Essebag,Paul Novak,Allan C. Skanes,Carlos A. Morillo,Yaariv Khaykin,David H. Birnie +7 more
TL;DR: Asymptomatic episodes were more likely AFL/AT and were significantly shorter and slower, with lower heart rate variability, however, the postablation state was the strongest independent predictor of asymPTomatic AF.
Journal ArticleDOI
Prevalence, Predictors, and Prognosis of Atrial Fibrillation Early After Pulmonary Vein Isolation: Findings from 3 Months of Continuous Automatic ECG Loop Recordings
Sandeep Joshi,Andrew D. Choi,Ganesh S. Kamath,Farbod Raiszadeh,Daniel Marrero,Apurva Badheka,Suneet Mittal,Suneet Mittal,Jonathan S. Steinberg,Jonathan S. Steinberg +9 more
TL;DR: This study characterizes early recurrences and determines implications of early AF following PVI, and describes pulmonary vein isolation for atrial fibrillation as a “blanking period.”
Journal ArticleDOI
Venice chart international consensus document on atrial fibrillation ablation: 2011 update
Antonio Raviele,Andrea Natale,Hugh Calkins,John Camm,Riccardo Cappato,Shih Ann Chen,Stuart J. Connolly,Ralph J. Damiano,Roberto De Ponti,James R. Edgerton,Michel Haãssaguerre,Gerhard Hindricks,Siew Yen Ho,José Jalife,Paulus Kirchhof,Hans Kottkamp,Karl H. Kuck,Francis E. Marchlinski,Douglas L. Packer,Carlo Pappone,Eric N. Prystowsky,Vivek Reddy,Sakis Themistoclakis,Atul Verma,David J. Wilber,Stephan Willems +25 more
TL;DR: The Venice Chart International Consensus Document on Atrial Fibrillation Ablation : 2011 Update shows a clear trend in opinion on how best to treat atrial fibrillation.
References
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Journal ArticleDOI
Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins
Michel Haïssaguerre,Pierre Jaïs,D. C. Shah,Atsushi Takahashi,Mélèze Hocini,G Quiniou,S. Garrigue,A Le Mouroux,P Le Métayer,Jacques Clementy +9 more
TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Journal ArticleDOI
Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study.
Emelia J. Benjamin,Daniel Levy,Sonya M. Vaziri,Ralph B. D'Agostino,Albert J. Belanger,Philip A. Wolf +5 more
TL;DR: In addition to intrinsic cardiac causes such as valve disease and congestive heart failure, risk factors for cardiovascular disease also predispose to atrial fibrillation.
Journal ArticleDOI
Initiation of Atrial Fibrillation by Ectopic Beats Originating From the Pulmonary Veins Electrophysiological Characteristics, Pharmacological Responses, and Effects of Radiofrequency Ablation
Shih Ann Chen,Ming Hsiung Hsieh,Ching Tai Tai,Chin Feng Tsai,V. S. Prakash,Wen Chung Yu,Tsui Lieh Hsu,Yu An Ding,Mau Song Chang +8 more
TL;DR: Electrophysiological characteristics of PVs are different from those in the atria, and careful mapping and elimination of these ectopic foci can cure paroxysmal AF.
Journal ArticleDOI
Pulmonary Vein Isolation for Paroxysmal and Persistent Atrial Fibrillation
Hakan Oral,Bradley P. Knight,Hiroshi Tada,Mehmet Ozaydin,Aman Chugh,Sohail Hassan,Christoph Scharf,Steve W.K. Lai,Radmira Greenstein,Frank Pelosi,S. Adam Strickberger,Fred Morady +11 more
TL;DR: The clinical efficacy of pulmonary vein isolation is much lower when AF is persistent than when it is paroxysmal, and with a segmental isolation approach that targets at least 3 PVs, a clinically satisfactory result can be achieved in >80% of patients with paroxYSmal AF.
Journal ArticleDOI
Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia.
Robert L. Page,William E. Wilkinson,Walter K. Clair,Elizabeth A. McCarthy,Edward L.C. Pritchett +4 more
TL;DR: It is not known whether asymptomatic atrial fibrillation is a potential risk factor for stroke even when patients are not having symptomatic arrhythmias, but in a group of patients with paroxysmal atrialfibrillation, sustained asymptic arrhythmia occurs far more frequently than symptomatic atrian fibrilation.
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