Redefining the Blanking Period by a Long-Term Follow-Up after Atrial Fibrillation Ablation Using Second-Generation Cryoballoon

被引:8
作者
Xia, Yu [1 ]
Liu, Jun [1 ]
Jia, Yuhe [1 ]
Zhang, Hao [2 ]
Yu, Miao [1 ]
Li, Xiaofeng [1 ]
Fang, Pihua [1 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis, Cardiac Arrhythmia Ctr,Fuwai Hosp, 167 North Lishi Rd, Beijing 10037, Peoples R China
[2] Chongqing Gen Hosp, Dept Cardiol, Chongqing, Peoples R China
关键词
Arrhythmia; Pulmonary vein isolation; Early recurrence; Electrocardiogram; EXPERT CONSENSUS STATEMENT; PULMONARY VEIN ISOLATION; CATHETER ABLATION; EARLY RECURRENCES; RADIOFREQUENCY ABLATION; SURGICAL ABLATION; ARRHYTHMIAS; MANAGEMENT; TIME; AF;
D O I
10.1536/ihj.20-234
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
On the basis of radiofrequency ablation of atrial fibrillation (AF), some studies suggested that early recurrences of atrial tachyarrhythmia (ERATs) were associated with late AF recurrence (LAFR), and some also suspected and challenged the current recommended 90 day blanking period. We aim to evaluate the impact of ERsr on long-term success and to determine the optimum blanking period after AF ablation using second-generation cryoballoon (sg-CB). From August 2016 to October 2018, 369 consecutive patients who successfully underwent initial AF ablation using sg-CB at the Fuwai Hospital were finally enrolled. All patients were followed up no less than 12 months. Receiver operating characteristic curve analysis was used to determine the optimum blanking period after AF ablation. There were 62 (16.8%) who experienced ERAT. After a median follow-up of 615 days. 74.5% were free of LAFR after the 90 day blanking period. Incidence of freedom from LAFR during the long-term follow-up was markedly lower in patients with ERAT than in those without ERAT (27.4% versus 84.0%; log-rank P < 0.001). Furthermore, only ERAT (HR 8.579; 95% CI 5.604-13.133; P < 0.001) was significantly associated with an increased risk of LAFR after adjusting for other factors. The optimum cut-off time point for the blanking period was 21.5 days (sensitivity: 71.1%, specificity: 94.1%). In conclusion, ERAT was an independent predictor of LAFR after AF ablation using sg-CB. Based on our findings, blanking period was advised to be shorten to 21.5 days or about 3 weeks instead of 90 days after CB ablation.
引用
收藏
页码:936 / 943
页数:8
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