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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
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15. Valvular Heart Disease
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18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
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Are symptoms a reliable marker of arrhythmia recurrence after atrial fibrillation ablation?
Session:
Posters 4 - Écran 08 - Arritmologia Invasiva
Speaker:
Guilherme Portugal
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.8 Atrial Fibrillation - Clinical
Session Type:
Posters
FP Number:
---
Authors:
Guilherme Portugal; Catarina Barroso; Mário Martins Oliveira; Pedro Silva Cunha; Bruno Tereno Valente; Rita Ilhão Moreira; Madalena Coutinho Cruz; Teresa Gomes; Ana Sofia Delgado; Rui Cruz Ferreira
Abstract
<p>Background:</p> <p>Recurrence of atrial arrhythmias (AF/AT) occurs in over 30% of patients (P) after an index atrial fibrillation (AF) ablation procedure. During follow-up, in addition to electrocardiographic screening, P are also inquired for the presence of symptoms suggesting arrhythmias. However, whether these symptoms represent true AF/AT recurrence is unclear. </p> <p>Methods:</p> <p>We prospectively enrolled consecutive P submitted to AF ablation (paroxysmal and persistent) to undergo external loop recorder (ELR) monitoring up to 3 months after AF ablation. P-activated events (PAE) were manually reviewed for presence or absence of AF/AT. Presence of at least one PAE with underlying AF/AT was classified as concordance. Analysis of the relationship between PAE and AF/AT was performed with Fisher exact test and estimation of sensitivity and specificity.</p> <p>Results:</p> <p>A total of 171 subjects were included, mean age 53.3 +/- 10.4 yrs, 62% male sex, left atrial diameter 43.5 +/- 8.1 mms, 54% paroxysmal AF, 38% persistent AF, 8% long standing persistent AF. During ELR, ≥1 AF/AT episode was observed in 33.7% of P. Symptoms were present in 73 (45.9%) P. Of these, only 39.7% were correlated with any AF/AT. There was no significant relation between symptoms and AF/AT (p=0.243). Estimated sensitivity and specificity of PAEs for recurrence of AF/AT was 52.7% and 57.7%, respectively. Furthermore, AF/AT recurrence was assymptomatic in 47.2% of subjects. At 1 year follow-up, the presence of symptoms was not associated with recurrence of AF (p=NS).</p> <p>Conclusions:</p> <p>Patient-referred symptoms are an unreliable marker for incidence of AF/AT after AF ablation. In addition, nearly half of AF/AT recurrences were assymptomatic. Systematic electrocardiographic monitoring strategies are warranted to allow an accurate depiction of AF ablation success.</p>
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