Journal of arrhythmia · 2020
Predictive value of noninducibility after catheter ablation for paroxysmal and persistent atrial fibrillation.
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Tachibana Shinichi, Mizukami Akira, Kuroda Shunsuke, Hayashi Tatsuya, Matsumura Akihiko, Goya Masahiko, Sasano Tetsuo
Аннотация
BACKGROUND: It is unclear whether pacing maneuver at the end of catheter ablation for atrial fibrillation (AF) predicts recurrence of atrial tachyarrhythmia postintervention.
OBJECTIVE: To investigate whether the predictive value of incremental pacing maneuver after catheter ablation for AF depends on the pacing cycle length and type of AF.
METHODS: This study included 298 consecutive patients who underwent initial catheter ablation for nonvalvular AF (61% paroxysmal AF [PAF], 39% persistent AF [PeAF]). Rapid atrial pacing was performed at the end of the procedure. We analyzed minimum coupling interval (CI) of pacing, arrhythmia-inducibility, and atrial tachyarrhythmia recurrence in patients with PAF and PeAF.
RESULTS: Patients were divided into the following three groups according to their response to pacing maneuver: AF-inducible (inducible group; n = 86), noninducible at CI ≥200 ms (non-CI ≥200 group; n = 100), and noninducible at CI <200 ms (non-CI <200 group; n = 112). Kaplan-Meier analysis showed that response to pacing maneuver was significantly associated with recurrence of atrial tachyarrhythmias (P = .028). Cox-regression analysis showed that non-CI <200 was an independent predictor when the inducible group was used as a reference (hazard ratio 0.60, 95% confidence interval 0.40-0.96, P = .031). However, when PAF and PeAF were analyzed separately, non-CI <200 was an independent predictor only in PeAF.
CONCLUSION: Noninducibility with shorter CI predicted atrial tachyarrhythmia recurrence only for PeAF. Pacing CI and type of AF could influence the predictive value of atrial tachyarrhythmia recurrence.
OBJECTIVE: To investigate whether the predictive value of incremental pacing maneuver after catheter ablation for AF depends on the pacing cycle length and type of AF.
METHODS: This study included 298 consecutive patients who underwent initial catheter ablation for nonvalvular AF (61% paroxysmal AF [PAF], 39% persistent AF [PeAF]). Rapid atrial pacing was performed at the end of the procedure. We analyzed minimum coupling interval (CI) of pacing, arrhythmia-inducibility, and atrial tachyarrhythmia recurrence in patients with PAF and PeAF.
RESULTS: Patients were divided into the following three groups according to their response to pacing maneuver: AF-inducible (inducible group; n = 86), noninducible at CI ≥200 ms (non-CI ≥200 group; n = 100), and noninducible at CI <200 ms (non-CI <200 group; n = 112). Kaplan-Meier analysis showed that response to pacing maneuver was significantly associated with recurrence of atrial tachyarrhythmias (P = .028). Cox-regression analysis showed that non-CI <200 was an independent predictor when the inducible group was used as a reference (hazard ratio 0.60, 95% confidence interval 0.40-0.96, P = .031). However, when PAF and PeAF were analyzed separately, non-CI <200 was an independent predictor only in PeAF.
CONCLUSION: Noninducibility with shorter CI predicted atrial tachyarrhythmia recurrence only for PeAF. Pacing CI and type of AF could influence the predictive value of atrial tachyarrhythmia recurrence.