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Effect of pulmonary vein isolation on atrial fibrillation recurrence after ablation of paroxysmal supraventricular tachycardia in patients with high dispersion of atrial refractoriness

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Abstract

Purpose

This study aimed to assess pulmonary vein isolation (PVI) efficacy on atrial fibrillation (AF) recurrence and to determine a predictive dispersion of atrial refractoriness (dERP) value for performing PVI in paroxysmal supraventricular tachycardia (PSVT) patients.

Methods

Of 67 PSVT patients with past AF episodes who underwent accessory pathway (AP) or slow pathway of atrioventricular node ablation, 63 (4 lost to follow-up or death) were assigned into two groups (A and B; 29 and 34 patients, respectively) based on whether they underwent or not subsequent PVI, and all were followed-up up to 3 years. Atrial effective refractory period (AERP) and dERP were measured during the ablation procedure.

Results

In receiver operating characteristic (ROC) curve analysis, dERP = 74.5 ms effectively predicted AF recurrence in PSVT patients (p = 0.003). Difference in AF recurrence rate between groups did not reach statistical significance (17.2 %, 5/29 vs. 29.4 %, 10/34, p = 0.203). AF recurrence rate was lower in patients with dERP >74.5 ms who underwent AP or slow-pathway ablation with vs. without PVI (18.2 %, 2/11 vs. 77.8 %, 7/9, p = 0.012).

Conclusions

PVI addition after successful AP or slow pathway of atrioventricular node ablation significantly reduced AF recurrence in PSVT patients with high atrial vulnerability (dERP >74.5 ms).

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Acknowledgments

This study was sponsored by the Natural Science Foundation of China (81270238) and the Scientific Research Foundation for Doctoral Degree, State Education Ministry of China (20130131110065).

Conflict of interest

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Authors and Affiliations

  1. Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Shandong, China

    Zhen-xing Xu, Jing-quan Zhong, Bing Rong, Xin Yue, Zhao-tong Zheng, Qing Zhu, Shao-lei Yi, Jun-tao Wang, Man Li & Yun Zhang

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  1. Zhen-xing Xu
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  2. Jing-quan Zhong
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  3. Bing Rong
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Correspondence to Jing-quan Zhong.

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Xu, Zx., Zhong, Jq., Rong, B. et al. Effect of pulmonary vein isolation on atrial fibrillation recurrence after ablation of paroxysmal supraventricular tachycardia in patients with high dispersion of atrial refractoriness. J Interv Card Electrophysiol 41, 169–175 (2014). https://doi.org/10.1007/s10840-014-9937-4

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  • DOI: https://doi.org/10.1007/s10840-014-9937-4

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