Premature atrial contraction immediately after catheter ablation was associated with late recurrence of atrial fibrillation
Premature atrial contraction immediately after catheter ablation was associated with late recurrence of atrial fibrillation
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DOI：
10.1111/pace.14648
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发表时间：
2022-12-27
影响因子：
1.8
通讯作者：
Yamaguchi，Osamu
中科院分区：
文献类型：
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作者：
Fujisawa，Tomoki;Kawakami，Hiroshi;Yamaguchi，Osamu
心房颤动（AF）导管消融（CA）后的房性期前收缩（PAC）是常见的，但其临床意义尚不明确。本研究旨在评估是否PAC负担后，初始CA AF与晚期recurrence.MethodsWe招募了346例AF患者（中位年龄，65岁; 30%女性; 57%阵发性AF）谁经历了初始射频CA和24小时霍尔特监测后的一天程序。PAC被定义为室上性复合波发生≥30%，早于预期相比，以前的RR间隔，PAC/24小时的数量在程序后的霍尔特monitored进行了analyzed.ResultsAF复发106例（31%）在中位随访19个月。这些患者的PAC/24 h显著高于无PAC/24 h的患者（中位数[四分位距]，891 [316-4351]次vs. 409 [162- 1，303]次;p< 0.01）。在调整临床参数和左心房（LA）扩大后，PAC数量与AF复发独立相关。受试者工作特征（ROC）曲线分析显示，1431 PAC/24 h是预测AF复发的最佳截止值。将PAC/24 h添加到左心房直径预测模型中似乎可以正确地将被认为具有房颤复发高风险的患者重新分类为低风险组，反之亦然。首次CA后第二天的24小时霍尔特记录是房颤复发风险分层的一种简单而有益的工具。
BackgroundAlthough premature atrial contractions (PACs) just after catheter ablation (CA) for atrial fibrillation (AF) are common, their clinical significance is uncertain. This study aimed to evaluate whether the PAC burden after an initial CA for AF was associated with late recurrence.MethodsWe enrolled 346 patients with AF (median age, 65 years; 30% female; 57% with paroxysmal AF) who underwent an initial radiofrequency CA and a 24‐h Holter monitoring the day after the procedure. PAC was defined as supraventricular complexes occurring ≥30% earlier than expected compared with a previous RR interval, and the number of PAC/24 h during post‐procedural Holter monitoring was analyzed.ResultsAF recurred in 106 patients (31%) during a median follow‐up of 19 months. These patients had significantly more PAC/24 h than those without (median [interquartile range], 891 [316–4351] beats vs. 409 [162–1,303] beats;p< 0.01). The number of PACs was independently associated with AF recurrence after adjustment for clinical parameters and left atrial (LA) enlargement. Receiver operating characteristic (ROC) curve analysis revealed that 1431 PAC/24 h was the optimal cut‐off value for predicting AF recurrence. Adding the PAC/24 h to the prediction model with LA diameter appeared to correctly reclassify patients who were thought to be at high risk for AF recurrence into the low‐risk group and vice versa.ConclusionsThe number of PACs was an independent risk factor for AF recurrence. A 24‐h Holter recording the day after an initial CA is a simple and beneficial tool for the risk stratification of AF recurrence.