Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence
The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. In this prospective study, 114 patients with at least 3 documented AF episodes together...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2005-07, Vol.112 (3), p.307-313 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | HINDRICKS, Gerhard PIORKOWSKI, Christopher TANNER, Hildegard KOBZA, Richard GERDS-LI, Jin-Hong CARBUCICCHIO, Corrado KOTTKAMP, Hans |
| description | The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation.
In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.104.518837 |
| format | Article |
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In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P<0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF.
Even in patients presenting with highly symptomatic AF, asymptomatic episodes may occur and significantly increase after catheter ablation. A symptom-only-based follow-up would substantially overestimate the success rate. Objective measures such as long-term Holter monitoring are needed to identify asymptomatic AF recurrences after ablation.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.104.518837</identifier><identifier>PMID: 16009793</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Adult ; Aged ; Anti-Arrhythmia Agents - therapeutic use ; Atherosclerosis (general aspects, experimental research) ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Atrial Flutter - physiopathology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Catheter Ablation ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Recurrence ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>Circulation (New York, N.Y.), 2005-07, Vol.112 (3), p.307-313</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c330t-a8eebdc8a2f1326f39ba88c384caed76b3a18c54a3a1787a345bb30fce5bec3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,3691,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16987091$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16009793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HINDRICKS, Gerhard</creatorcontrib><creatorcontrib>PIORKOWSKI, Christopher</creatorcontrib><creatorcontrib>TANNER, Hildegard</creatorcontrib><creatorcontrib>KOBZA, Richard</creatorcontrib><creatorcontrib>GERDS-LI, Jin-Hong</creatorcontrib><creatorcontrib>CARBUCICCHIO, Corrado</creatorcontrib><creatorcontrib>KOTTKAMP, Hans</creatorcontrib><title>Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation.
In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P<0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF.
Even in patients presenting with highly symptomatic AF, asymptomatic episodes may occur and significantly increase after catheter ablation. A symptom-only-based follow-up would substantially overestimate the success rate. Objective measures such as long-term Holter monitoring are needed to identify asymptomatic AF recurrences after ablation.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Atrial Flutter - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Catheter Ablation</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctu2zAQJIoWjZP2Fwr20N7kkiIlUb0ZRh4GjKYIkrOwpJYwCz3cpRzAH5D_LmMLaHta7OzMkLvD2GcpllKW8tt687B-2q4eN_c_VnerpRR6WUhjVPWGLWSR60wXqn7LFkKIOqtUnl-wyxh_pbZUVfGeXcgyTapaLdjLTySH-ymMAx89h4kCdNwHS6Hr4ARb9CMhh6Hl4CckTtCG0RP-PuDgjtzBtMNXHOys-M4fsMNnGByeTOOx309jn4aOA9HuOO36AJzQHYiSB35g7zx0ET_O9Yo93Vw_ru-y7f3tZr3aZk4pMWVgEG3rDOReqrz0qrZgjFNGO8C2Kq0CaVyhIdXKVKB0Ya0S3mFh0SmrrtjXs--exvT7ODV9iA7TpgOOh9iURhRKaJ2I9ZnoaIyR0Dd7Cj3QsZGiec2g-T-DBOvmnEHSfpofOdge27_K-eiJ8GUmQHTQeUqHCvEfXm0qUUv1B5Falbw</recordid><startdate>20050719</startdate><enddate>20050719</enddate><creator>HINDRICKS, Gerhard</creator><creator>PIORKOWSKI, Christopher</creator><creator>TANNER, Hildegard</creator><creator>KOBZA, Richard</creator><creator>GERDS-LI, Jin-Hong</creator><creator>CARBUCICCHIO, Corrado</creator><creator>KOTTKAMP, Hans</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050719</creationdate><title>Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence</title><author>HINDRICKS, Gerhard ; PIORKOWSKI, Christopher ; TANNER, Hildegard ; KOBZA, Richard ; GERDS-LI, Jin-Hong ; CARBUCICCHIO, Corrado ; KOTTKAMP, Hans</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c330t-a8eebdc8a2f1326f39ba88c384caed76b3a18c54a3a1787a345bb30fce5bec3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Adult</topic><topic>Aged</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Atrial Flutter - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Catheter Ablation</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HINDRICKS, Gerhard</creatorcontrib><creatorcontrib>PIORKOWSKI, Christopher</creatorcontrib><creatorcontrib>TANNER, Hildegard</creatorcontrib><creatorcontrib>KOBZA, Richard</creatorcontrib><creatorcontrib>GERDS-LI, Jin-Hong</creatorcontrib><creatorcontrib>CARBUCICCHIO, Corrado</creatorcontrib><creatorcontrib>KOTTKAMP, Hans</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HINDRICKS, Gerhard</au><au>PIORKOWSKI, Christopher</au><au>TANNER, Hildegard</au><au>KOBZA, Richard</au><au>GERDS-LI, Jin-Hong</au><au>CARBUCICCHIO, Corrado</au><au>KOTTKAMP, Hans</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2005-07-19</date><risdate>2005</risdate><volume>112</volume><issue>3</issue><spage>307</spage><epage>313</epage><pages>307-313</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation.
In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P<0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF.
Even in patients presenting with highly symptomatic AF, asymptomatic episodes may occur and significantly increase after catheter ablation. A symptom-only-based follow-up would substantially overestimate the success rate. Objective measures such as long-term Holter monitoring are needed to identify asymptomatic AF recurrences after ablation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16009793</pmid><doi>10.1161/CIRCULATIONAHA.104.518837</doi><tpages>7</tpages></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2005-07, Vol.112 (3), p.307-313 |
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| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Adrenergic beta-Antagonists - therapeutic use Adult Aged Anti-Arrhythmia Agents - therapeutic use Atherosclerosis (general aspects, experimental research) Atrial Fibrillation - epidemiology Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Atrial Flutter - physiopathology Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Catheter Ablation Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Electrocardiography Female Heart Rate Humans Male Medical sciences Middle Aged Prospective Studies Recurrence Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence |
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