Rethinking appropriate blanking period after atrial fibrillation ablation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-02-16 DOI:10.1007/s10840-024-01754-6

Naoaki Onishi, Akihira Suenaga, Akinori Yoshida, Takayasu Kobayashi, Shokan Kyo, Maki Oi, Nobuya Higashitani, Fumiko Nakazeki, Naofumi Oyamada, Toshikazu Jinnai, Kazuaki Kaitani

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引用次数: 0

Abstract

Background: Early recurrence (ER) within a 90-day blanking period (BP) in catheter ablation (CA) for atrial fibrillation (AF) is a risk factor for late recurrence (LR) after 90 days postoperatively. However, few reports have examined them in the second CA and compared them to the first CA. Moreover, in recent years, there have been reports suggesting that BP should be reduced from 90 to 30 days. Therefore, the association between ER and LR in the first and the second CA was examined, and the validity of a 30-day BP was evaluated.

Methods: A total of 511 consecutive patients undergoing the first CA and 116 of these patients undergoing the second CA for AF at a single institution from November 2016 to December 2020 were analyzed retrospectively.

Results: When ER within a 90-day BP was divided into 0-30 days and 31-90 days according to the timing of the last ER episode, the hazard ratios on LR of them relative to no ER were 2.7 {95% confidence interval (CI) 1.7-4.2} and 9.7 (95% CI 6.6-14.3), respectively, for the first CA and 15.3 (95% CI 4.7-50.1) and 44.1 (95% CI 14.0-139.4), respectively, for the second CA.

Conclusions: ER was strongly associated with LR, especially in patients with the last episode of ER more than 30 days after CA. This was pronounced in cases after the second CA, when PVI appeared to be completed. With the current improvement in PVI durability, BP may be acceptable for 30 days.

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重新思考心房颤动消融术后的适当空白期。

背景：心房颤动（房颤）导管消融术（CA）90 天空白期（BP）内的早期复发（ER）是术后 90 天后晚期复发（LR）的风险因素。然而，很少有报告对第二次心房颤动导管消融术中的BP进行研究，并将其与第一次心房颤动导管消融术进行比较。此外，近年来有报告建议应将血压从 90 天降至 30 天。因此，我们研究了第一和第二CA中ER和LR之间的关联，并评估了30天血压的有效性：方法：回顾性分析了2016年11月至2020年12月在一家机构接受首次CA治疗的511名连续患者和其中接受第二次CA治疗的116名房颤患者：根据最后一次ER发作的时间将90天BP内的ER分为0-30天和31-90天，第一次CA的ER相对于无ER的LR危险比分别为2.7{95%置信区间（CI）1.7-4.2}和9.7（95% CI 6.6-14.3），第二次CA的ER相对于无ER的LR危险比分别为15.3（95% CI 4.7-50.1）和44.1（95% CI 14.0-139.4）：ER与LR密切相关，尤其是在CA后30天以上发生ER的患者中。这在第二次 CA 后的病例中更为明显，当时 PVI 似乎已经完成。随着目前 PVI 耐用性的提高，30 天内的血压是可以接受的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.