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A strategy of rapid cardioversion minimizes the significance of early recurrent atrial tachyarrhythmias after ablation for atrial fibrillation.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2011 Jul; Vol. 22 (7), pp. 761-6. Date of Electronic Publication: 2011 Mar 08. - Publication Year :
- 2011
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Abstract
- Background: The significance of early recurrent atrial tachyarrhythmias after atrial fibrillation (AF) ablation is unclear. Atrial remodeling driven by these tachyarrhythmias can result in electrical, contractile, and structural changes that may impair long-term therapy success. Aggressive attempts to restore sinus rhythm in the temporal period of healing after ablation might improve outcomes.<br />Methods: A total of 1,759 AF ablations were performed at Intermountain Medical Center or LDS Hospital. A total of 455 of those were among patients requiring repeat ablations. Patients were instructed to take their pulse daily and, if greater than 100 bpm or irregular, present the following business day fasting to the clinic for evaluation and cardioversion if AF or atrial flutter (AFL) were present.<br />Results: Of the ablations performed, a total of 515 (29%, age: 65.6 ± 11.2 years, male: 57.9%) developed AF/AFL that required cardioverison. The majority of these arrhythmias first occurred in the initial 90 days (63.7%) postablation. During this period, 62.8% were on an antiarrhythmic drug (AAD). Only 25.1% were using an AAD at 3 months. The majority of ablations (75.6%) who experienced AF/AFL within the first 90 days after ablation were in sinus rhythm with no AAD at 1 year. Further, 48% of those with the first recurrence from 90 to 180 days were in sinus rhythm with no AAD at 1 year.<br />Conclusions: The time at which the first recurrence of AF/AFL occurs impacts long-term outcomes. An aggressive strategy of rapid cardioversion postablation reduces the significance of recurrent AF/AFL during the first 6 months.<br /> (© 2011 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Databases, Factual
Electric Countershock adverse effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
Registries
Secondary Prevention
Tachycardia epidemiology
Tachycardia etiology
Time Factors
Atrial Fibrillation physiopathology
Atrial Fibrillation therapy
Electric Countershock methods
Tachycardia physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 22
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 21385263
- Full Text :
- https://doi.org/10.1111/j.1540-8167.2010.02005.x