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Use of an implantable monitor to detect arrhythmia recurrences and select patients for early repeat catheter ablation for atrial fibrillation: a pilot study.

https://arctichealth.org/en/permalink/ahliterature131176
Source
Circ Arrhythm Electrophysiol. 2011 Dec;4(6):823-31
Publication Type
Article
Date
Dec-2011
Author
Evgeny Pokushalov
Alexander Romanov
Giorgio Corbucci
Sergey Artyomenko
Alex Turov
Natalya Shirokova
Alexander Karaskov
Author Affiliation
State Research Institute of Circulation Pathology, Novosibirsk, Russia. E.Pokushalov@gmail.com
Source
Circ Arrhythm Electrophysiol. 2011 Dec;4(6):823-31
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Aged
Analysis of Variance
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - diagnosis - physiopathology - surgery
Catheter Ablation - adverse effects
Chi-Square Distribution
Electrocardiography, Ambulatory - instrumentation
Equipment Design
Female
Heart rate
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Patient Selection
Pilot Projects
Predictive value of tests
Prospective Studies
Pulmonary Veins - physiopathology - surgery
Recurrence
Reoperation
Russia
Time Factors
Treatment Outcome
Abstract
Catheter ablation of atrial fibrillation (AF) has proved effective in curing highly symptomatic patients with paroxysmal AF. The aim of this prospective, randomized study was to identify the optimal treatment of patients with AF recurrences after the first ablation.
Two hundred eighty-six patients with paroxysmal AF underwent ablation (circumferential pulmonary vein isolation with linear lesions) and were monitored with an implantable cardiac monitor (Reveal XT, Medtronic). Patients without AF recurrences during the 3-month postablation period were assigned to group 1; those with AF recurrences to group 2. Patients in group 2 were randomly assigned to group 3 or group 4. Group 3 patients were treated only with antiarrhythmic drugs for 6 weeks, with no early reablation during the 3-month postablation period. In the case of AF recurrence after the 3-month postablation period, patients underwent reablation. Group 4 patients were treated according to the onset mechanism of AF recurrences, as detected and stored by the implantable cardiac monitor: antiarrhythmic drug therapy, but no reablation if AF was not preceded by triggers; early reablation if premature atrial beats or atrial tachycardias or flutter triggered AF. All patients were followed up for 1 year to assess maintenance of sinus rhythm in each group. On 12-month follow-up examination, of the 119 (42%) patients in group 1, 112 (94%) had no AF recurrences. Among the 83 patients in group 3, only 27 (33%) had no recurrences. Of the 84 group 4 patients, 67 (80%) had no AF recurrences (P
Notes
Comment In: Circ Arrhythm Electrophysiol. 2011 Dec;4(6):791-322203657
PubMed ID
21930653 View in PubMed
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