Association of pulmonary vein isolation and major cardiovascular events in patients with atrial fibrillation

Girod, M; Coslovsky, Michael; Aeschbacher, Stefanie; Sticherling, Christian; Reichlin, Tobias; Roten, Laurent; Rodondi, Nicolas; Ammann, Peter; Auricchio, Angelo; Moschovitis, Giorgio; Kobza, Richard; Badertscher, Patrick; Knecht, Sven; Krisai, Philipp; Marugg, Andrea; Aebersold, Helena; Hennings, Elisa; Serra-Burriel, Miquel; Schwenkglenks, Matthias; Zuern, Christine S.; Bonati, Leo H.; Conen, David; Oßwald, Stefan; Kühne, Michael

doi:10.1007/s00392-022-02015-0

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Pulmonary vein isolation (PVI) is a frequently used and efficient medical intervention to restore sinus rhythm in AF patients with the aim to reduce AF symptoms (10,11). Despite new evidence showing that PVI reduces heart failure hospitalizations and other cardiac events (12)(13)(14)(15), the potential positive or negative effects of rhythm control by means of PVI or the procedure itself on neurocognitive function is unknown. New cerebral lesions after PVI are well described (16)(17)(18), and may result in neurocognitive impairment (19).…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation

Zwimpfer

Aeschbacher²,

Krisai³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAtrial fibrillation (AF) is associated with cognitive dysfunction. However, neurocognitive function in AF patients undergoing pulmonary vein isolation (PVI) has not been well studied. The aim of this analysis is to compare neurocognitive function in patients who did or did not undergo PVI.Materials and methodsWe used data from the Swiss Atrial Fibrillation Cohort study (Swiss-AF), a prospective, observational, multicenter study in Switzerland. Patients with documented AF were enrolled and data of 1,576 patients without history of PVI and with complete information on PVI status and neurocognitive function were used. Information on PVI was collected at baseline and during 1 year of follow-up. Neurocognitive testing was performed at baseline and after 1 year of follow-up, using the Montreal Cognitive Assessment (MoCA), trail making test (TMT) A and B, digit symbol substitution test (DSST) and semantic fluency test (SFT). To investigate the association of PVI with neurocognitive function, we use propensity score matching (1:3) and inverse probability of treatment weighting (IPTW).ResultsThe mean age of this population was 74 ± 8 years, 27.1% were women. Overall, 88 (5.5%) patients underwent PVI during 1 year of follow-up. Using ITPW (n = 1576), PVI was weakly associated with the MoCA score after adjusting for time since PVI, baseline MoCA score and other covariates (β (95%CI) 1.19 (0.05; 2.32), p = 0.04). In the propensity matched comparison (n = 352), there was no significant association between PVI and the MoCA score (β (95%CI) 1.04 (−0.19; 2.28), p = 0.1). There were no significant associations between PVI and cognitive function when using the TMT A and B, DSST or SFT independent of the method used.ConclusionIn this population of AF patients, there was no consistent evidence of an association between PVI and neurocognitive function.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT02105844].

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Section: Introductionmentioning

confidence: 99%

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation

Zwimpfer

Aeschbacher²,

Krisai³

et al. 2022

Front. Cardiovasc. Med.

Self Cite

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Clinical utility of the 4S-AF scheme in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation

Cui,

Li,

Sun

et al. 2024

Preprint

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Background: The 4S-AF scheme, consisting of four domains related to atrial fibrillation (AF) [stroke risk (St), symptoms (Sy), severity of AF burden (Sb), and substrate (Su)], represents a novel approach for the structural characterization of AF. We aimed to assess the clinical utility of the scheme in predicting AF recurrence after radiofrequency catheter ablation (RFCA). Methods: We prospectively enrolled 345 consecutive patients with AF who underwent initial RFCA between January 2019 and December 2019. The 4S-AF scheme score was calculated and used to characterize AF. The primary outcome assessed was AF recurrence after RFCA, defined as any documented atrial tachyarrhythmia episode lasting at least 30 seconds. Results: Of 345 patients [age 61 (IQR: 53-68) years, 34.2% female, 70.7% paroxysmal AF] were analyzed. The median duration of AF history was 12 (IQR: 3-36) months, and the median number of comorbidities was 2 (IQR: 1-3), and 157 (45.5%) patients had left atrial enlargement. During a median follow-up period of 28 (IQR: 13-37) months, AF recurrence occurred in 34.4% of patients. Both 4S-AF scheme score (HR 1.38, 95% CI: 1.19?1.59, P<0.001) and 2S-AF scheme by eliminating the Sy and St domains (HR 1.59, 95% CI: 1.33?1.89, P<0.001) were independent predictors of AF recurrence after RFCA. For each domain, we found that the independent predictors were Sb (HR 1.84, 95% CI: 1.25?2.72, P=0.002) and Su (HR 1.71, 95% CI: 1.36?2.14, P<0.001). Furthermore, 4S-AF scheme score (AUC 65.2%, 95% CI: 59.3?71.1) and 2S-AF scheme score (AUC 66.2%, 95% CI: 60.2?72.1) had a modest ability to predict AF recurrence after RFCA. Conclusions: The novel 4S-AF scheme is feasible for evaluating and characterizing AF patients who undergo RFCA and aids us in identifying patients with a high risk of AF recurrence after RFCA.

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Association of pulmonary vein isolation and major cardiovascular events in patients with atrial fibrillation

Cited by 2 publications

References 24 publications

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation

Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation

Clinical utility of the 4S-AF scheme in predicting recurrence of atrial fibrillation after radiofrequency catheter ablation

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