Perception of atrial fibrillation before and after radiofrequency catheter ablation : Relevance of asymptomatic arrhythmia recurrence

The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. In this prospective study, 114 patients with at least 3 documented AF episodes together...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2005-07, Vol.112 (3), p.307-313
Main Authors: HINDRICKS, Gerhard, PIORKOWSKI, Christopher, TANNER, Hildegard, KOBZA, Richard, GERDS-LI, Jin-Hong, CARBUCICCHIO, Corrado, KOTTKAMP, Hans
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Anti-Arrhythmia Agents - therapeutic use
Atherosclerosis (general aspects, experimental research)
Atrial Fibrillation - epidemiology
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Atrial Flutter - physiopathology
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Catheter Ablation
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Electrocardiography
Female
Heart Rate
Humans
Male
Medical sciences
Middle Aged
Prospective Studies
Recurrence
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary:The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.104.518837