Defining the blanking period, using continuous ECG monitoring, after cryoballoon pulmonary vein isolation
Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. A blanking period (BP) of 3 months is used in clinical trials and practice. However, the optimal BP duration after PVI remains undefined.
OBJECTIVE: The aim of this study was to objectively define, using continuous monitoring by an implantable loop recorder, the optimal BP duration after cryoballoon PVI.
METHODS: We enrolled consecutive patients who had cryoballoon PVI and an implantable loop recorder. We determined the time of the last confirmed episode of AF within the blanking period. This was then correlated with AF recurrence in the first year after ablation.
RESULTS: There were 210 patients (66 ± 9 years; 138 [66%] male; 116 [55%] paroxysmal AF; CHA2DS2-VASc score, 2.5 ± 1.6). We defined 4 distinct groups based on the last AF episode within the BP: no AF days 0-90 (n = 96 [46%]) and last AF 0-30 days (n = 46 [22%]), 31-60 days (n = 18 [9%]), and 61-90 days (n = 50 [24%]). After the 3-month BP, 101 (48%) patients had AF recurrence at 160 ± 86 days. Compared with patients with no AF in the BP, those with recurrent AF and AF burden >0% 30 days after ablation had a significantly greater AF recurrence during long-term follow-up (P = .001).
CONCLUSION: Our data show that the approximately one-third of patients in whom AF occurs and who have a burden of >0% after the first month that follows PVI are at significantly higher risk of long-term recurrent AF. We therefore suggest that the blanking period be limited to a month after cryoballoon PVI.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Heart rhythm - (2024) vom: 11. Feb. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Musat, Dan L [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Atrial fibrillation |
|---|
| Anmerkungen: |
Date Revised 17.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.hrthm.2024.02.014 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36840627X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36840627X | ||
| 003 | DE-627 | ||
| 005 | 20240317233043.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240214s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.hrthm.2024.02.014 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1333.xml |
| 035 | |a (DE-627)NLM36840627X | ||
| 035 | |a (NLM)38350520 | ||
| 035 | |a (PII)S1547-5271(24)00132-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Musat, Dan L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Defining the blanking period, using continuous ECG monitoring, after cryoballoon pulmonary vein isolation |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 17.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. A blanking period (BP) of 3 months is used in clinical trials and practice. However, the optimal BP duration after PVI remains undefined | ||
| 520 | |a OBJECTIVE: The aim of this study was to objectively define, using continuous monitoring by an implantable loop recorder, the optimal BP duration after cryoballoon PVI | ||
| 520 | |a METHODS: We enrolled consecutive patients who had cryoballoon PVI and an implantable loop recorder. We determined the time of the last confirmed episode of AF within the blanking period. This was then correlated with AF recurrence in the first year after ablation | ||
| 520 | |a RESULTS: There were 210 patients (66 ± 9 years; 138 [66%] male; 116 [55%] paroxysmal AF; CHA2DS2-VASc score, 2.5 ± 1.6). We defined 4 distinct groups based on the last AF episode within the BP: no AF days 0-90 (n = 96 [46%]) and last AF 0-30 days (n = 46 [22%]), 31-60 days (n = 18 [9%]), and 61-90 days (n = 50 [24%]). After the 3-month BP, 101 (48%) patients had AF recurrence at 160 ± 86 days. Compared with patients with no AF in the BP, those with recurrent AF and AF burden >0% 30 days after ablation had a significantly greater AF recurrence during long-term follow-up (P = .001) | ||
| 520 | |a CONCLUSION: Our data show that the approximately one-third of patients in whom AF occurs and who have a burden of >0% after the first month that follows PVI are at significantly higher risk of long-term recurrent AF. We therefore suggest that the blanking period be limited to a month after cryoballoon PVI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Blanking period | |
| 650 | 4 | |a Catheter ablation | |
| 650 | 4 | |a Cryoballoon pulmonary vein isolation | |
| 650 | 4 | |a Implantable loop recorder | |
| 700 | 1 | |a Milstein, Nicolle S |e verfasserin |4 aut | |
| 700 | 1 | |a Saberito, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Bhatt, Advay |e verfasserin |4 aut | |
| 700 | 1 | |a Habibi, Mohammadali |e verfasserin |4 aut | |
| 700 | 1 | |a Sichrovsky, Tina C |e verfasserin |4 aut | |
| 700 | 1 | |a Preminger, Mark W |e verfasserin |4 aut | |
| 700 | 1 | |a Shaw, Richard E |e verfasserin |4 aut | |
| 700 | 1 | |a Mittal, Suneet |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Heart rhythm |d 2004 |g (2024) vom: 11. Feb. |w (DE-627)NLM154896640 |x 1556-3871 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:11 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.hrthm.2024.02.014 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 11 |c 02 | ||