Catheter Ablation of Lone Atrial Fibrillation

Mujović, Nebojša; Marinković, Milan; Potpara, Tatjana; Gellér, László

doi:10.2174/1381612820666140825144226

Cited by 15 publications

(42 citation statements)

References 153 publications

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“…Post-procedural finding of any symptomatic or asymptomatic atrial tachyarrhythmia (AF, atrial tachycardia [AT] and/or typical atrial flutter [AFL]) lasting >30 sec was considered the arrhythmia recurrence12. The recurrences registered within the 3-month “blanking period” after ablation were classified as the early recurrence of AF (ERAF)12.…”

Section: Methodsmentioning

confidence: 99%

“…The recurrences registered within the 3-month “blanking period” after ablation were classified as the early recurrence of AF (ERAF)12. The off-AADs recurrences occurring after the “blanking period” but between 3 and 12 months after the procedure were considered the late recurrence of AF (LRAF), and the recurrences documented more than 12 months after the procedure were classified as VLRAF12789. Patients with LRAF or VLRAF were offered a redo CA procedure or re-institution of AAD therapy.…”

Section: Methodsmentioning

confidence: 99%

“…Catheter-ablation (CA) is superior to antiarrhythmic drugs (AADs) in patients with symptomatic atrial fibrillation (AF), but AF may re-occur despite multiple re-do procedures and recent technical improvements12. Most arrhythmia recurrences are identified within the first year after the procedure, while further long-term follow-up strategy for initially “successfully” treated patients is less well defined and inconsistently reported123456789.…”

mentioning

confidence: 99%

“…It is reported that 10–40% of patients who were arrhythmia free within the first post-procedural year experienced very late recurrence of AF (VLRAF) over long-term follow-up23456789. Several scoring systems (i.e., the APPLE, ALARMc and BASE-AF2 score) were recently proposed to predict the short-term risk of AF recurrence after the procedure101112.…”

mentioning

confidence: 99%

“…However, none of these scores have addressed VLRAF occurring in patients who were free of AF at 1 year post procedure. Importantly, reliable identification of increased risk of VLRAF could strongly influence decision-making regarding the long-term use of oral anticoagulation and/or AAD therapy as well as the long-term monitoring strategy after the procedure12. Due to altered risk/benefit ratio, multiple AF ablation procedures may not be justified in patients at high risk of recurrent AF, and reliable prediction of VLRAF could optimize the patient selection for re-do CA12911.…”

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confidence: 99%

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Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: The MB-LATER clinical score

Mujović

Marinković

Marković

et al. 2017

Sci Rep

102

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Reliable prediction of very late recurrence of atrial fibrillation (VLRAF) occuring >12 months after catheter ablation (CA) in apparently "cured" patients could optimize long-term follow-up and modify decision-making regarding the discontinuation of oral anticoagulant therapy. In a single-centre cohort of consecutive patients post radiofrequency AFCA, we retrospectively derived a novel score for VLRAF prediction. Of 133 consecutive post AFCA patients (mean age 56.9 ± 11.8 years, 63.9% male, 69.2% with paroxysmal AF) who were arrhythmia-free at 12 months (excluding 3-month "blanking period"), Catheter-ablation (CA) is superior to antiarrhythmic drugs (AADs) in patients with symptomatic atrial fibrillation (AF), but AF may re-occur despite multiple re-do procedures and recent technical improvements 1,2 . Most arrhythmia recurrences are identified within the first year after the procedure, while further long-term follow-up strategy for initially "successfully" treated patients is less well defined and inconsistently reported 1-9 .Several studies described a progressive increase in the arrhythmia recurrence rates over time in patients with initial post-ablation suppression of AF 4-6 . It is reported that 10-40% of patients who were arrhythmia free within the first post-procedural year experienced very late recurrence of AF (VLRAF) over long-term follow-up 2-9 . Several scoring systems (i.e., the APPLE, ALARMc and BASE-AF2 score) were recently proposed to predict the short-term risk of AF recurrence after the procedure 10-12 . However, none of these scores have addressed VLRAF occurring in patients who were free of AF at 1 year post procedure. Importantly, reliable identification of increased risk of VLRAF could strongly influence decision-making regarding the long-term use of oral anticoagulation and/or AAD therapy as well as the long-term monitoring strategy after the procedure 1,2 . Due to altered risk/benefit ratio, multiple AF ablation procedures may not be justified in patients at high risk of recurrent AF, and reliable prediction of VLRAF could optimize the patient selection for re-do CA 1,2,9,11 .

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: The MB-LATER clinical score

Mujović

Marinković

Marković

et al. 2017

Sci Rep

102

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Left atrial appendage size is a marker of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation

Simon

Mahdiui

Smit

et al. 2021

Clinical Cardiology

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Introduction There are no consistently confirmed predictors of atrial fibrillation (AF) recurrence after catheter ablation. Therefore, we aimed to study whether left atrial appendage volume (LAAV) and function influence the long‐term recurrence of AF after catheter ablation, depending on AF type. Methods AF patients who underwent point‐by‐point radiofrequency catheter ablation after cardiac computed tomography (CT) were included in this analysis. LAAV and LAA orifice area were measured by CT. Uni‐ and multivariable Cox proportional hazard regression models were performed to determine the predictors of AF recurrence. Results In total, 561 AF patients (61.9 ± 10.2 years, 34.9% females) were included in the study. Recurrence of AF was detected in 40.8% of the cases (34.6% in patients with paroxysmal and 53.5% in those with persistent AF) with a median recurrence‐free time of 22.7 (9.3–43.1) months. Patients with persistent AF had significantly higher body surface area‐indexed LAV, LAAV, and LAA orifice area and lower LAA flow velocity, than those with paroxysmal AF. After adjustment left ventricular ejection fraction (LVEF) <50% (HR = 2.17; 95% CI = 1.38–3.43; p < .001) and LAAV (HR = 1.06; 95% CI = 1.01–1.12; p = .029) were independently associated with AF recurrence in persistent AF, while no independent predictors could be identified in paroxysmal AF. Conclusion The current study demonstrates that beyond left ventricular systolic dysfunction, LAA enlargement is associated with higher rate of AF recurrence after catheter ablation in persistent AF, but not in patients with paroxysmal AF.

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Functional promoter −1816C>G variant of RANKL predicts risk and prognosis of lone atrial fibrillation

Cao

Chen

et al. 2018

Heart Vessels

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Receptor activator of nuclear factor-κB ligand (RANKL) had been confirmed contributing to the development and progression of AF by regulating atrial structural remodeling. But the involved genetic mechanism is unknown. We intended to explore the association between the polymorphism RANKL -1816C>G (rs7984870) and susceptibility and prognosis of lone AF. RANKL rs7984870 was genotyped in a case-control study of 828 patients and 834 controls in Chinese population. The CG and/or CC genotypes had an increased lone AF risk [adjusted odds ratio (OR) 1.20 for CG, OR 2.16 for CC, and OR 1.55 for CG/CC], compared with the GG genotype. Moreover, patients carrying CG/CC genotypes showed a higher possibility of AF recurrence after catheter ablation, compared with patients carrying GG genotype. In a genotype-phenotype correlation analysis using 24 normal left atrial appendage samples, increasing gradients of atrial RANKL expression levels positively correlated with atrial collagen volume fraction were identified in samples with CC, CG and GG genotypes. The in vitro luciferase assays also showed a higher luciferase activity of the -1816 C/C allele than that of the -1816 G/G allele. These results suggested that RANKL rs7984870 is involved in the etiology of lone AF and thus may be a marker for genetic susceptibility to lone AF and predicting prognosis after catheter ablation in Chinese populations. Therefore, we provide new information about treatment strategies and our understanding of RANKL in AF.

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Catheter Ablation of Lone Atrial Fibrillation

Cited by 15 publications

References 153 publications

Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: The MB-LATER clinical score

Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: The MB-LATER clinical score

Left atrial appendage size is a marker of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation

Functional promoter −1816C>G variant of RANKL predicts risk and prognosis of lone atrial fibrillation

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