Reproducibility and predictive value of a simple novel method to measure atrial fibrillation cycle length in persistent atrial fibrillation - FARS-AF study

© 2022 Wiley Periodicals LLC..

INTRODUCTION: Different methods are used for atrial fibrillation (AF) cycle length (CL) measurement with variable results. Previous studies of pulmonary vein (PV) CL measurement showed contradictory results on predicting PV isolation (PVI) efficacy. A novel simple method of measuring the average of 10 consecutive Fastest Atrial Repetitive Similar morphology signal (FARS10 )-CL to characterize local atrial activity rate was evaluated prospectively.

METHODS: The intra-observer reproducibility of FARS10 -CL and traditional AF-CL measurement of continuously fragmented coronary sinus (CS) signals were tested. We prospectively enrolled 100 consecutive patients (62 ± 10 years, 72% male) undergoing wide antral PVI only ablation for persistent AF, measured PV-FARS10 -CLs, and evaluated long-term outcome.

RESULTS: The Kendall area correlation between repeated traditional AF-CL measurements was -0.006 and between repeated FARS10 -CL measurements in the right and left atrial appendages, CS and PVs were 0.944, 0.859, 0.882, 0.675-0.955, respectively. Patients with recurrent atrial tachyarrhythmia had significantly longer fastest PV-FARS10 -CL (172 ± 41 vs. 156 ± 41 ms, p = .047). Patients with high burden of spontaneous low-voltage zone (LVZ) had significantly longer fastest PV-FARS10 -CL. Freedom from recurrent tachyarrhythmia at 24 months was 85% versus 59% in patients with fastest PV-FARS10 -CL ≤ 140 versus >140 ms, p = .0018, respectively. In multivariable analysis fastest PV-FARS10 -CL ≤ 140 ms was the only significant predictor of freedom from recurrent tachyarrhythmia.

CONCLUSIONS: FARS10 -CL measurements have a high reproducibility in contrast to traditional AF-CL measurement of continuously fragmented CS signals. Patients with high burden of LVZ have longer fastest PV-FARS10 -CLs. Fastest PV-FARS10 -CL ≤ 140 ms is associated with a high success of wide antral PVI-only ablation approach in persistent AF.

Errataetall:

CommentIn: J Cardiovasc Electrophysiol. 2022 Apr;33(4):651-653. - PMID 35132726

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:33

Enthalten in:

Journal of cardiovascular electrophysiology - 33(2022), 4 vom: 01. Apr., Seite 641-650

Sprache:

Englisch

Beteiligte Personen:

Spera, Francesco [VerfasserIn]
Rodriguez-Mañero, Moises [VerfasserIn]
Baluja, Aurora [VerfasserIn]
Saenen, Johan [VerfasserIn]
Huybrechts, Wim [VerfasserIn]
Miljoen, Hielko [VerfasserIn]
Tijskens, Maxime [VerfasserIn]
Vandaele, Lien [VerfasserIn]
Wittock, Anouk [VerfasserIn]
Claeys, Marc J [VerfasserIn]
Heidbuchel, Hein [VerfasserIn]
Sarkozy, Andrea [VerfasserIn]

Links:

Volltext

Themen:

Atrial fibrillation ablation
Atrial fibrillation cycle length
Journal Article
Persistent atrial fibrillation
Predictors AF ablation
Pulmonary vein isolation

Anmerkungen:

Date Completed 04.04.2022

Date Revised 06.06.2022

published: Print-Electronic

CommentIn: J Cardiovasc Electrophysiol. 2022 Apr;33(4):651-653. - PMID 35132726

Citation Status MEDLINE

doi:

10.1111/jce.15401

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM336651481