Incidence of Atrial Arrhythmias Detected by Permanent Pacemakers (PPM) Post-Pulmonary Vein Antrum Isolation (PVAI) for Atrial Fibrillation (AF): Correlation with Symptomatic Recurrence

Autor:	Atul Verma, Dimpi Patel, Patrick J. Tchou, Walid Saliba, David O. Martin, Fethi Kilicaslan, Stephen Minor, Steven Hao, Dhanumjaya Lakkireddy, S. Claude Elayi, J. David Burkhardt, R N Salwa Beheiry, Jennifer Cummings, Robert A. Schweikert, Andrea Natale
Rok vydání:	2007
Předmět:	Male Pacemaker Artificial medicine.medical_specialty medicine.medical_treatment Catheter ablation Asymptomatic Pulmonary vein Recurrence Interquartile range Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Atrial tachycardia Fibrillation business.industry Incidence Incidence (epidemiology) Atrial fibrillation Middle Aged medicine.disease United States Surgery Outcome and Process Assessment Health Care Pulmonary Veins Catheter Ablation Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies
Zdroj:	Journal of Cardiovascular Electrophysiology. 18:601-606
ISSN:	1540-8167 1045-3873
DOI:	10.1111/j.1540-8167.2007.00789.x
Popis:	Background: Studies examining AF recurrences post-PVAI base recurrence on patient reporting of symptoms. However, whether asymptomatic recurrences are common is not well known. Objective: To assess the incidence of atrial tachycardia/fibrillation post-PVAI as detected by a PPM and whether these recurrences correlate to symptomatic recurrence. Methods: Eighty-six consecutive patients with symptomatic AF and PPMs with programmable mode-switch capability underwent PVAI. Mode switching was programmed post-PVAI to occur at an atrial-sensed rate of >170 bpm. Patients were followed with clinic visits, ECG, and PPM interrogation at 1, 3, 6, and 9 months post-PVAI. The number and duration of mode-switching episodes (MSEs) were recorded at each visit and is presented as median (interquartile range). Results: The patients (age 57 ± 8 years, EF 54 ± 10%) had paroxysmal (65%) and persistent (35%) AF pre-PVAI. Sensing, pacing, and lead function were normal for all PPMs at follow-up. Of the 86 patients, 20 (23%) had AF recurrence based on symptoms. All 20 of these patients had appropriate MSEs detected. Of the 66 patients without symptomatic recurrence, 21 (32%) had MSEs detected. In 19 of these patients, MSEs were few in number, compared with patients with symptomatic recurrence (16 [4–256] vs 401 [151–2,470], P < 0.01). The durations were all
Databáze:	OpenAIRE
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