Abstract
Background
The significance of atrial fibrillation (AF) recurrences during the 90-day blanking period following catheter ablation is controversial. Studies to date examining the impact of AF recurrences during the blanking period have been limited by intermittent monitoring. We sought to test whether AF recurrences during the blanking period are associated with long-term recurrences using continuous monitoring.
Methods
Patients undergoing AF ablation by a single operator at an academic medical center between 2015 and 2019, who either already had a cardiac implantable electronic device (CIED) with an atrial lead or received an insertable cardiac monitor (ICM), were followed for long-term AF recurrence. Recurrence was defined as > 30 s by CIED and > 2 min by ICM. All device-reported AF episodes were adjudicated by a physician.
Results
Of 196 consecutive patients, 51 (26%) had AF recurrence in the blanking period and 145 (74%) did not. Over the year following ablation, those who had an AF recurrence in the blanking period were significantly more likely to have long-term AF recurrences than those without AF in the blanking period (log rank p < 0.001). The higher the burden of AF recurrences during the blanking period, the more likely AF was to recur long-term (hazard ratio 1.04 [CI 1.01–1.06] per 1% increase in burden, p = 0.002).
Conclusion
Using continuous monitoring of a sizable population, we confirmed that AF recurrences in the blanking period following ablation are in fact associated with long-term AF recurrences. The higher the burden of recurrence, the more likely AF is to recur long-term.
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Abbreviations
- AF:
-
Atrial fibrillation
- CIED:
-
Cardiac implantable electronic devices
- LTR:
-
Long-term recurrence
- ICM:
-
Insertable cardiac monitor
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Funding
This work was supported by the Mark Marchlinski EP Research & Education Fund.
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Drs. Amankwah, Pothineni, and Frankel made substantial contributions to the conception and design of the work, as well as acquisition, analysis, and interpretation of the data. All other authors critically revised the manuscript for important intellectual content and approved the submitted version. The authors read and approved the final manuscript.
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There are no potential conflicts of interest to disclose. All patients provided written informed consent and the study was approved by the Institutional Review Board.
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The authors declare that they have no competing interests.
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Amankwah, N.A., Pothineni, N.V.K., Guandalini, G. et al. Impact of atrial fibrillation recurrences during the blanking period following catheter ablation on long-term arrhythmia-free survival: a prospective study with continuous monitoring. J Interv Card Electrophysiol 65, 519–525 (2022). https://doi.org/10.1007/s10840-022-01291-0
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DOI: https://doi.org/10.1007/s10840-022-01291-0