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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
35. Research Methodology
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Do arrythmias during the blanking period predict late recurrence of atrial fibrillation after ablation?
Session:
CO 01 - Arritmologia Invasiva
Speaker:
Catarina Alexandra Barroso
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Catarina Barroso; Guilherme Portugal; Mário Martins Oliveira; Pedro Silva Cunha; Bruno Tereno Valente; Madalena Coutinho Cruz; Rita Ilhão Moreira; Rui Cruz Ferreira
Abstract
<p><strong><u>Introduction</u></strong></p> <p> Pulmonary vein isolation is an established treatment in patients with atrial fibrillation (AF). While atrial arrythmias (AA) are common during the first 3 months after ablation (blanking period), they are considered as being procedurally-related and not necessarily treatment failure. The aim of this study was to assess the prognostic value of arrythmias during the blanking period.</p> <p><strong><u>Methods</u></strong></p> <p> We prospectively enrolled consecutive patients submitted to AF ablation (paroxysmal and persistent) to undergo external loop recorder (ELR) monitoring up to 3 months after AF ablation. All events were manually reviewed for presence or absence of AA (AF, atrial flutter or atrial tachycardia). Recurrence of atrial fibrillation was systematically assessed at 1-year follow-up; patients with clinical AF requiring cardioversion during the blanking period were excluded. The relationship between AA and recurrence of AF at 1 year was analysed with use of the chi-square test and multivariate logistic regression analysis.</p> <p><strong><u>Results</u></strong></p> <p> 86 patients were included, mean age 55 +/- 12 years, 60,5% male sex, left atrial diameter 43,6 +/- 9,3 mms, 58.1% paroxysmal and 41.9% persistent AF. AA during the blanking period were observed in 25.6% of patients. At one year, more patients with AA during the blanking period had recurrence of AF (40.9% vs 18.7%, p=0.037). The Kaplan-Meier plot for freedom from AF according to the presence of AA during the blanking period is depicted on Figure 1. After multivariate logistical regression, persistent AF (odds ratio 1.74) and AA during blanking period (odds ratio 3.2, CI 1.077-9.52, p=0.036) were independent predictors of recurrent AF.</p> <p><u><strong>Conclusions</strong></u></p> <p>Atrial arrythmias during the blanking period are linked to late recurrence of AF.</p> <p>Further data are needed to understand the clinical significance of this finding.</p>
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