Heart rhythm最新文献

{"title":"Risk factors of late arrhythmia recurrences over 12 months after catheter ablation of atrial fibrillation: Insight into atrial cardiomyopathy.","authors":"Yasuharu Matsunaga-Lee, Koichi Inoue, Nobuaki Tanaka, Masaharu Masuda, Tetsuya Watanabe, Hitoshi Minamiguchi, Yasuyuki Egami, Takafumi Oka, Miwa Miyoshi, Masato Okada, Yasuhiro Matsuda, Masato Kawasaki, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Masamichi Yano, Masami Nishino, Shungo Hikoso, Akihiro Sunaga, Tomoharu Dohi, Katsuki Okada, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata","doi":"10.1016/j.hrthm.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.018","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Validation of a Pre-Specified Algorithm for the Management of Conduction Disturbances Following Transcatheter Aortic Valve Replacement. The PROMOTE Study.","authors":"Josep Rodés-Cabau, Luis Nombela-Franco, Guillem Muntané-Carol, Gabriela Veiga, Ander Regueiro, Tamim Nazif, Vicenç Serra, Lluis Asmarats, Henrique B Ribeiro, Azeem Latib, Anthony Poulin, Asim N Cheema, Pilar Jiménez-Quevedo, Joan Antoni Gomez-Hospital, Aritz Gil Ongay, Rami Gabani, Dabit Arzamendi, Michael Brener, Alvaro Calabuig, Andrea Scotti, Marco Antonio S Gelain, Marino Labinaz, Pedro Cepas, Jorge Nuche, Melanie Côté, Juan H Del Portillo, François Philippon","doi":"10.1016/j.hrthm.2024.12.019","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.019","url":null,"abstract":"<p><strong>Background: </strong>There is a large variability regarding the management of conduction disturbances (CDs) after TAVR.</p><p><strong>Objectives: </strong>To validate a pre-specified algorithm for managing CDs in patients undergoing TAVR.</p><p><strong>Methods: </strong>Prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR. Patients were stratified in different groups according to the presence of prior right bundle branch block (RBBB) and the occurrence of CDs during the procedure: no prior RBBB and no CDs (group NCD), prior RBBB and no CDs (group RBBB-NCD), and occurrence of CDs (group CD). A management algorithm was pre-specified for each group. Permanent pacemaker (PPM) and mortality (overall, sudden cardiac death) at 30 days were the primary endpoints.</p><p><strong>Results: </strong>A total of 2110 TAVR recipients were included. Patients were distributed in NCD (32.0%), RBBB-NCD (5.1%), and CD (62.9%) groups. . A total of 329 patients (15.6%) received a PPM at 30 days , with a PPM rate of 5.5%, 15.9%, 20.7%, in NCD, RBBB-NCD, and CD groups, respectively (p<0.001). The PPM rate was 17.4% and 57.2% in patients with procedural new-onset LBBB and HAVB/CHB, respectively. There were no differences in 30-day all-cause mortality and sudden cardiac death between groups (NCD: 1.2/0.2%, RBBB-NCD: 0/0%, CDs 0.7/0.1%; p=0.45/0.99 for all-cause mortality and sudden cardiac death, respectively).</p><p><strong>Conclusions: </strong>A pre-specified strategy for the management of CDs in contemporary TAVR recipients was feasible and safe, with no increased mortality and an extremely low rate of sudden cardiac death among patients with CDs. However, PPM rates remained high, and continued efforts for preventing the occurrence of CDs are warranted.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pentaspline catheter or cryoballoon for pulmonary vein plus posterior wall isolation in persistent atrial fibrillation: 1-year outcomes.","authors":"Luigi Pannone, Ioannis Doundoulakis, Domenico Giovanni Della Rocca, Antonio Sorgente, Antonio Bisignani, Giampaolo Vetta, Alvise Del Monte, Giacomo Talevi, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Ali Gharaviri, Mark La Meir, Pedro Brugada, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis","doi":"10.1016/j.hrthm.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.020","url":null,"abstract":"<p><strong>Background: </strong>Left atrial posterior wall isolation (LAPWI) plus pulmonary vein isolation (PVI) can be performed with either radiofrequency, cryoballoon (CB-A) or, recently, with pulsed field ablation (PFA).</p><p><strong>Objective: </strong>The aim of this study is: (1) to evaluate efficacy and safety of the pentaspline PFA catheter for PVI + LAPWI in patients with persistent AF undergoing an index ablation procedure and (2) to compare 1- year outcomes of PVI + LAPWI with PFA vs CB-A.</p><p><strong>Methods: </strong>All consecutive patients undergoing to an index ablation for persistent atrial fibrillation (AF) at Universitair Ziekenhuis Brussel, Belgium, between 2021 and 2023, were retrospectively screened. Inclusion criteria were: 1) Persistent AF diagnosis following current guidelines; 2) First AF ablation procedure with PVI + LAPWI using the CB-A or the pentaspline PFA catheter; 3) 1-year follow-up completed.</p><p><strong>Results: </strong>A total of 160 patients were included (80 with CB-A and 80 with the pentaspline PFA catheter). PVI + LAPWI was performed with success in 160 (100%) patients and isolation was confirmed at post-procedure high-density mapping in all. Compared with CB-A, PFA was associated with shorter skin-to-skin procedure time, shorter LA dwell time and shorter fluoroscopy time. At survival analysis, freedom from recurrent atrial tachyarrhythmias at 1-year follow-up was similar between CB-A and PFA groups (76.2% vs 78.8%, Log-Rank p=0.63).</p><p><strong>Conclusion: </strong>In patients with persistent AF undergoing an index catheter ablation, the pentaspline PFA catheter is safe and effective for PVI + LAPWI. Outcomes after pentaspline PFA catheter ablation at 1-year are favorable and similar to CB-A catheter.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Focal Lattice Tip Catheter Toggling Between Pulsed Field Energy and Radiofrequency for Atrial Arrhythmia Ablation: Results from a Real-World, Multicenter Registry.","authors":"Giampaolo Vetta, Domenico G Della Rocca, Andrea Sarkozy, Roberto Menè, Luigi Pannone, Alexandre Almorad, Antonio Sorgente, Andres Betancur, Lorenzo Marcon, Sahar Mouram, Erwin Stroker, Ioannis Doundoulakis, Ivan Eltsov, Ourania Kariki, Alvise Del Monte, Ingrid Overeinder, Charles Audiat, Kazutaka Nakasone, Vasileios Sousonis, Wael Zaher, Gezim Bala, Kostantinos P Letsas, Stephane Combes, Juan Sieira, Michael Efremidis, Serge Boveda, Carlo de Asmundis, Gian-Battista Chierchia","doi":"10.1016/j.hrthm.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.021","url":null,"abstract":"<p><strong>Introduction: </strong>A novel focal lattice tip catheter allowing the delivery of either pulsed field (PF) or radiofrequency (RF) energy has recently received regulatory approval. The technology features a proprietary 3D electroanatomical mapping system.</p><p><strong>Objective: </strong>to describe the first real-world and multicentre experience.</p><p><strong>Methods: </strong>Consecutive AF patients undergoing first-time or redo atrial tachyarrhythmia ablation with the Affera^TM system were prospectively enrolled at three different centres. PF was the only energy source allowed when ablating the posterior left atrium; anterior applications were performed using either RF (PF/RF strategy) or PF (PF/PF strategy) based on operator's preference. The primary efficacy endpoint included acute electrical isolation of pulmonary veins and posterior wall, or bidirectional block in case of linear lesions.</p><p><strong>Results: </strong>130 patients [mean age: 67±10 years; 63.8%(n=83) males; 61.5%(n=80) non-paroxysmal AF; 55.4% first-time AF ablation] were included. First-time PVI was performed in 72 pts: RF/PF in 13(18.1%) patients and PF/PF in the remaining 59(81.9%); first-pass isolation for PV and PW isolation were achieved in 100% of cases. A total of 289 ablation lines were performed [roof line:91pts; inferior line:83pts; anterior mitral line (AML):32pts; posterior mitral lines (PML):45pts; cavotricuspid isthmus (CTI) line:38pts]. First-pass isolation and primary efficacy endpoint were 96.2% (roof line:100%; inferior line:100%; AML:96.9%; PML:84.4%; CTI:92.1%) and 100%, respectively. We had two (1.5%) major complications: one ST-segment elevation at the infero-lateral leads requiring intracoronary nitrate administration and one complete atrioventricular block.</p><p><strong>Conclusions: </strong>Catheter ablation via a novel 9-mm lattice tip catheter confirmed high efficacy and safety in a real-world scenario.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Atrial and Ventricular Arrhythmias using Multiple Cardiovascular Risk Factor Polygenic Risk Scores.","authors":"Julia Ramírez, Stefan van Duijvenboden, Michele Orini, Pier D Lambiase, Andrew Tinker, William J Young, Patricia B Munroe","doi":"10.1016/j.hrthm.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.017","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) prediction improves by combining clinical scores with a polygenic risk score (PRS) for AF (AF-PRS), but there are limited studies of PRS for ventricular arrhythmia (VA) prediction.</p><p><strong>Objective: </strong>We assessed the value of including multiple PRS for cardiovascular risk factors (CV-PRS) for incident AF and VA prediction.</p><p><strong>Methods: </strong>We used 158,733 individuals of European ancestry from UK Biobank to build three models for AF: CHARGE-AF (AF1), AF1 + AF-PRS (AF2), AF2 + CV-PRS (AF3). Models for VA included sex and age (VA1), VA1 + coronary artery disease (CAD) PRS (CAD-PRS, VA2), and VA2 + CV-PRS (VA3), conducting separate analyses in subjects with and without ischemic heart disease (IHD). Performance was evaluated in individuals of European (N=158,733), African (N=7,200), South Asian (N=9,241) and East Asian (N=2,076) ancestry from UK Biobank.</p><p><strong>Results: </strong>AF2 had a higher C-index than AF1 (0.762 versus 0.746, P<0.001), marginally improving to 0.765 for AF3 (P<0.001, including PRS for heart failure, electrocardiogram and cardiac magnetic resonance measures). In South Asians, AF2 C-index was higher than AF1 (P<0.001). For VA, the C-index for VA2 was greater than VA1 (0.692 versus 0.681, P<0.001) in Europeans, which was also observed in South Asians (P<0.001). VA3 improved prediction of VA in individuals with IHD.</p><p><strong>Conclusion: </strong>CV-PRS improved AF prediction compared to CHARGE-AF and AF-PRS. A CAD-PRS improved VA prediction, while CV-PRS contributed in IHD. AF- and CAD-PRS were transferable to individuals of South Asian ancestry. Our results inform of the use of CV-PRS for personalised screening.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of inter-atrial conduction delay during Bachmann's bundle pacing and right atrial appendage pacing using bi-atrial strain rate echocardiography.","authors":"Daisuke Yoshimoto, Yuichiro Sakamoto, Yukou Uemura, Ryo Yamaguchi, Hirokazu Naganawa, Takahiko Suzuki","doi":"10.1016/j.hrthm.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.016","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical Dyssynchrony Mapping and Optimization of Nonresponders in Patients Programmed with the Adaptive Cardiac Resynchronization Therapy Algorithm.","authors":"Alan J Bank, Kevin V Burns, Christopher D Brown, Evan Walser-Kuntz, Madeline A Czeck, Robert G Hauser, Jay D Sengupta","doi":"10.1016/j.hrthm.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.012","url":null,"abstract":"<p><strong>Background: </strong>The Adaptive cardiac resynchronization therapy (CRT) algorithm (aCRT) provides important clinical benefit. However, a significant number of patients are nonresponders.</p><p><strong>Objective: </strong>The purpose of this study was to quantify electrical synchrony in patients programmed with aCRT and to assess the effect of optimization on nonresponders.</p><p><strong>Methods: </strong>We studied 125 patients programmed with aCRT and measured electrical synchrony at multiple device settings using novel electrical dyssynchrony mapping (EDM) technology. Electrical synchrony was quantified as cardiac resynchronization index (CRI), a measure that analyzes areas between multiple pairs of anterior and posterior electrograms and calculates synchrony normalized to native rhythm.</p><p><strong>Results: </strong>CRI improved from baseline aCRT settings to optimal settings based on EDM (56±29% vs 92±12%, p<0.001). Patients programmed with LV-only aCRT (Group 1, n=68) had a greater CRI (62±25% vs 48±31%, p=0.014) than patients programmed with biventricular (BiV) aCRT (Group 2, n=57). In Group 1 and Group 2 respectively, optimal CRI during sequential BiV (92±13%, 93±9%) and LV-only (92±6%, 91±7%) pacing was significantly (p<0.001) greater than baseline aCRT CRI. In a subset of 53 nonresponders optimized using EDM there were significant improvements in CRI (37±25%, p<0.0001), LV ejection fraction (6.2±6.6%, p<0.0001), end-diastolic volume (9.5±28.2 ml, p=0.015), end-systolic volume (13.4±24.9 ml, p<0.001), and transverse (1.5±4.4%, p=0.014), longitudinal (1.0±2.5%, p=0.003) and circumferential (2.6±8.5%, p=0.047) strain.</p><p><strong>Conclusion: </strong>Electrical synchrony improves 56% with CRT using aCRT programming and 92% with EDM optimization. Optimization of aCRT-programmed non-responders results in significant improvements in LV size and systolic function offering the possibility of converting CRT nonresponders into responders.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel risk predictor of arrhythmias for patients with potassium channel related congenital Long-QT Syndrome.","authors":"Christian Krijger Juarez, Virginnio M Proost, Michael W Tanck, Sven Dittmann, J Martijn Bos, Lia Crotti, Julien Barc, Maarten P van den Berg, Jasmin Mujkanovic, Corinna Rickert, Raquel Almeida Lopes Neves, Giulia Musu, Federica Dagradi, Fulvio L F Giovenzana, Aurélien Clédel, Aurélie Thollet, John R Giudicessi, Jacob Tfelt-Hansen, Vincent Probst, Peter J Schwartz, Michael J Ackerman, Eric Schulze-Bahr, Connie R Bezzina, Arthur A M Wilde","doi":"10.1016/j.hrthm.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.015","url":null,"abstract":"<p><strong>Background: </strong>Congenital long-QT syndrome (LQTS) is characterized by delayed ventricular repolarization, predisposing to potentially lethal ventricular arrhythmias. The variability in disease severity among patients remains largely unexplored, underscoring the limitations of current risk stratification methods.</p><p><strong>Objective: </strong>We aimed to evaluate the potential utility of exercise stress test (EST) electrocardiographic markers in identifying high-risk LQTS patients.</p><p><strong>Methods: </strong>The study, which considered LQT1 and LQT2 patients, comprised a discovery cohort of 695 and a validation cohort of 635 patients.</p><p><strong>Results: </strong>The change in QTc between rest and recovery (between rest and 3-4 minutes into recovery period, called Recovery-Rest ΔQTc) was consistently greater in symptomatic patients. Sensitivity analyses conducted on EST data obtained on and off BB as well as upon distinguishing between patients with a baseline QTC below or above 470 milliseconds (ms), demonstrated consistent findings. The association of Recovery-Rest ΔQTc with cardiac events remained significant in a sub-analysis focussing on future events (i.e. occurring after EST). An optimal Recovery-Rest ΔQTc cut-off was determined for LQT1 (35 ms) and LQT2 (16 ms) separately and was shown to be significantly associated with cardiac events.</p><p><strong>Conclusion: </strong>Our findings suggest that in LQTS patients, dynamic QT interval measures obtained on EST are associated with lifetime arrhythmic events, and events following EST. Such measures can be helpful in identifying a higher-risk subset of LQTS patients in order to optimize their management. Further research may confirm these findings in larger cohorts, and explore the potential benefit of combining genetic and EST data for more precise risk stratification.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LONG TERM OUTCOMES OF GANGLIONATED-PLEXUS ABLATION AS SOLE THERAPY FOR PAROXYSMAL ATRIAL FIBRILLATION.","authors":"Jamie Kay, Min-Young Kim, Clare Coyle, David R Tomlinson, Louisa Malcolme-Lawes, Elaine Lim, Michael Fudge, Ian J Wright, Michael Koa-Wing, Fu Siong Ng, Norman A Qureshi, Zachary I Whinnett, Nicholas S Peters, Gurpreet Dhillon, Ross J Hunter, Phang Boon Lim, Nicholas W F Linton, Prapa Kanagaratnam","doi":"10.1016/j.hrthm.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.010","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of shortening the blanking period to 8 weeks after PVI: Insights from COMPARE-CRYO using continuous rhythm monitoring.","authors":"Salik Ur Rehman Iqbal, Thomas Kueffer, Sven Knecht, Patrick Badertscher, Jens Maurhofer, Philipp Krisai, Corinne Jufer, Gregor Thalmann, Nikola Kozhuharov, Valon Spahiu, Dik Heg, Helge Servatius, Hildegard Tanner, Michael Kühne, Laurent Roten, Christian Sticherling, Tobias Reichlin","doi":"10.1016/j.hrthm.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.12.013","url":null,"abstract":"<p><strong>Background: </strong>Early recurrences of atrial tachyarrythmias (ERAT) after pulmonary vein isolation (PVI) are common. While many correlate to late recurrences (LR), some do not. The impact of ERAT timing is difficult to assess with non-invasive holter monitoring due to undersampling. The recommended duration of the blanking period (BP) was recently shortened from 90 days to 8 weeks.</p><p><strong>Objective: </strong>To evaluate the impact of ERAT timing after PVI and the effect of a shorter BP, using implantable cardiac monitors (ICM) for continuous rhythm monitoring.</p><p><strong>Methods: </strong>This is a prespecified substudy of the COMPARE-CRYO study, which enrolled patients with paroxysmal atrial fibrillation undergoing cryoballoon ablation. All patients underwent ICM implantation and the BP duration was 90 days.</p><p><strong>Results: </strong>A total of 5285 ERAT episodes occurred in 117/201 patients (58%). Freedom from LR was 82% vs. 37% in patients without vs. with ERAT (p<0.001). When patients were classified according to their last episode of ERAT occurring between days 0-30, 31-60 and 61-90, freedom from LR was 60%, 56% and 11% (p<0.001). Seven of the 201 patients (3.4%) had AF recurrence in the third month after ablation, but not between days 91-365, which reclassifies them from ablation success to ablation failure with the shortened 8-week BP.</p><p><strong>Conclusion: </strong>ERAT after PVI is common. The presence of ERAT in the third month after PVI was highly predictive for ablation failure, supporting the shortening of the BP duration to 8 weeks, however, the shorter BP reclassifies 3.4% of the patients to ablation failure instead of ablation success.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}