scholarly journals Risk factors of atrial fibrillation recurrence despite successful radiofrequency ablation of accessory pathway: At 11 years of follow-up

2017 ◽  
Vol 24 (6) ◽  
pp. 597-603 ◽  
Author(s):  
Michał Orczykowski ◽  
Piotr Urbanek ◽  
Robert Bodalski ◽  
Paweł Derejko ◽  
Grzegorz Warmiński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Accessory Pathway ◽  
Atrial Fibrillation Recurrence

scholarly journals A novel predictive model of recurrence after surgical ablation of valvular atrial fibrillation

2021 ◽  
Author(s):  
Yali Wang ◽  
Xinlong Tang ◽  
Adili Ailiya ◽  
Can Xu ◽  
Xiyu Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Predictive Model ◽  
Early Recurrence ◽  
Function Parameter ◽  
Valvular Surgery ◽  
Risk Predictors ◽  
Af Recurrence

Background: Radiofrequency ablation(RFA) has emerged as a common approach to treatment of atrial fibrillation(AF) coupled with valve surgery. However, risk factors were rarely reported on recurrence after RFA of valvular atrial fibrillation . Methods: Retrospective study of a single-center database was performed in patients underwent valvular surgery combined with radiofrequency ablation. Follow-up was conducted from 3 months to 1 year after procedure. AF recurrence was defined as any episode of atrial arrhythmia lasting more than 30 seconds. Risk factors were analysis using Logistic regression and a predictive model was established. Results: 3-month follow-up was completed in 319 patients, 195 patients (61.1%) had AF recurrence. During the 1-year follow-up, 74 /166 patients(44.6%) had AF recurrence. Compared with sinus rhythm maintenance group, overweight(p=0.022), high BMI(p=0.024), large preoperative LAD(p<0.001), small MI area(p=0.019), large MI diameter(p<0.001) and other liver function parameter like low ALT level(p=0.023), high total bilirubin(p=0.013) and direct bilirubin level(p=0.033) were significantly correlated with AF recurrence after RF. In multivariate analysis, BMI(OR 1.12, 95% CI 1.04-1.21, p=0.003), LAD(OR 1.49, 95% CI 1.09-2.07, p=0.015), MI area(OR 0.41, 95% CI 0.18-0.85, p=0.023), MI diameter(OR 2.45, 95% CI 1.16-5.34, p=0.021), ALT(OR 0.98, 95% CI 0.97-0.99, p=0.002) and eGFR(OR 1.01, 95% CI 1.09-1.02, p=0.042) were significantly independent risk predictors of AF early recurrence. A predictive model was created with AUC of 0.720. Conclusions: BMI、LAD、MI area、MI diameter、ALT and eGFR were risk predictors of AF early recurrence. We established a predictive model and it devote to preoperative clinical health management of individual with valvular AF.

scholarly journals Analysis of the risk factors of valvular atrial fibrillation treated with radiofrequency ablation during valve replacement

2020 ◽  
Author(s):  
Xuan Liu ◽  
Fengjuan Xiao ◽  
Kai She ◽  
Jixiang Wang ◽  
Wei Xiong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Stenosis ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Recurrence ◽  
Rheumatic Mitral Stenosis ◽  
Risk Factors For Recurrence ◽  
Independent Risk Factors ◽  
And Gender

Abstract Purpose To investigate the risk factors of recurrence of atrial fibrillation(AF) after radiofrequency ablation in patients with rheumatic mitral stenosis with persistent atrial fibrillation. Methods From January 2015 to December 2018, patients undergoing radiofrequency ablation of rheumatic mitral stenosis complicated with persistent atrial fibrillation were collected. The patients were divided into sinus rhythm group(Group SR) and atrial fibrillation recurrence group (Group AR). collecting the data of preoperative echocardiography LV,LA,RA,RV,EF and gender, age, whether to combine diabetes, hypertension, etc. logistic regression was used to analyze the risk factors for atrial fibrillation recurrence. Results The success rate of 1 year after radiofrequency ablation was 76.8%. there was no difference in LV, LA, RV, RA, EF, and gender, age, diabetes, hypertension between the two groups, and there were no independent risk factors for recurrence of AF after radiofrequency ablation. Conclusion Rheumatic mitral stenosis with persistent atrial fibrillation has good therapeutic effect in patients undergoing radiofrequency ablation during valve replacement. LV, LA, RV, RA, EF, gender, age, diabetes, hypertension are not independent risk factors for recurrence of atrial fibrillation.

scholarly journals Catheter ablation for atrial fibrillation in very young patients

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
K Yalin ◽  
B Ikitimur ◽  
T Aksu ◽  
AU Soysal ◽  
E Lyan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Accessory Pathway ◽  
Young Patients ◽  
Old Patients ◽  
Index Procedure ◽  
Holter Ecg ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Pulmonary vein automaticity is an established trigger of paroxysmal atrial fibrillation (PAF) making pulmonary vein isolation (PVI)  the cornerstone for catheter ablation. However, data on triggers of AF and catheter ablation strategy in very young (&lt;30 years old) patients are sparse. Methods and results: Sixteen young patients (mean age 25.2 ± 4.9 years; 75% men) with recurrent drug refractory PAF underwent EP study and ablation at 3 EP centers. None of the patients had structural heart disease or family history of AF. EP study revealed degeneration of induced supraventricular tachycardia (SVT) into AF in 5 patients (n = 5, 31.2%). Induced SVTs were left lateral concealed accessory pathway mediated orthodromic AVRT in two patients, typical AVNRT in two patients, and left superior PV tachycardia in one patient respectively. In patients with induced SVTs, SVT ablation without PVI was performed as an index procedure. Remaining patients underwent second generation cryoballoon (CB-2) based PVI (n = 11, 68.7%). There were no major complications related to ablation procedures. Follow-up was based on outpatient visits including 24-h Holter-ECG at 3, 6 and, 12 months post ablation, or additional Holter-ECG was ordered in case of symptoms suggesting recurrence. Recurrence was defined as any atrial tachyarrhythmia (ATA) episode &gt;30s following a 3-month blanking period. After a median follow-up of 18.3 ± 6.2 months, 13 of 16 (81.2%) patients were free of ATA recurrence. None of the patients belonging to SVT ablation only group experienced ATA recurrence. Three patients with previous CB-2 PVI recurred, one had typical atrial flutter and underwent CTI ablation, remaining 2 patients had AF recurrence and medically followed. Conclusion In a considerable fraction of young adult patients with history of PAF SVTs may be responsible and SVT ablation without PVI may be sufficient as an index procedure. Catheter ablation AF seems to be safe and effective in this population.

scholarly journals The role of the accessory pathway radiofrequency catheter ablation in the secondary prevention of the malignant tachyarrhythmias in patients with Wolff-Parkinson-White syndrome

2010 ◽  
Vol 67 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Nebojsa Mujovic ◽  
Miodrag Grujic ◽  
Stevan Mrdja ◽  
Aleksandar Kocijancic ◽  
Tatjana Potpara ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Secondary Prevention ◽  
Emotional Stress ◽  
Drug Administration ◽  
Clinical Manifestation ◽  
Accessory Pathway

Background/Aim. The occurrence of atrial fibrillation (AF) in the presence of an accessory pathway (AP) that conducts rapidly is potentially lethal because the rapid ventricular response may lead to ventricular fibrillation (VF). The aim of the study was to determine long-term efficacy of AP catheter-ablation using radiofrequency (RF) current in secondary prevention of VF in WPW patients. Methods. Study included a total of 192 symptomatic WPW patients who underwent RF catheter-ablation of AP in our institution from 1994 to 2007 and were available for clinical follow-up for more than 3 months after procedure. Results. Before ablation, VF was recorded in total of 27 patients (14.1%). In 14 of patients (51.9%) VF was the first clinical manifestation of WPW syndrome. A total of 35 VF episodes were identified in 27 patients. The occurrence of VF was preceded by physical activity or emotional stress in 17.1% of cases, by alcohol abuse in 2.9% and by inappropriate intravenous drug administration in 28.6%. In addition, no clear precipitating factor was identified in 40% of VF cases, while informations about activities preceding 11.4% of VF episodes were not available. The follow-up of 5.7 ? 3.3 years was obtained in all of 27 VF patients. Of the 20 patients who underwent successful AP ablation, all were alive, without syncope or ventricular tachyarrhythmias during long-term follow-up. In 4 of 7 unsuccessfully treated patients, recurrence of supraventricular tachycardia and/or preexcited atrial fibrillation were recorded; one of these patients suddenly died of VF, 6 years after procedure. Conclusion. In significant proportion of WPW patients, VF was the first clinical manifestation of WPW syndrome, often precipitated by physical activity, emotional stress or inappropriate drug administration. Successful elimination of AP by percutaneous RF catheter-ablation is highly effective in secondary prevention of life-threatening tachyarrhythmias in patients with ventricular preexcitation.

scholarly journals Atrial Fibrillation in Hypertrophic Cardiomyopathy

2021 ◽  
Vol 11 (3) ◽  
pp. 173-185
Author(s):  
G. A. Ignatenko ◽  
G. G. Taradin ◽  
N. T. Vatutin ◽  
A. A. Kaluga ◽  
Yu. D. Kostyamin
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Hypertrophic Cardiomyopathy ◽  
Sinus Rhythm ◽  
Antiarrhythmic Drugs ◽  
Contemporary Literature ◽  
Clinical Manifestations ◽  
Detection Methods

The current information about features of atrial fibrillation in patients with hypertrophic cardiomyopathy is presented in this review. The data about prevalence, pathogenesis and its various complications in these patients are disclosed. The article contains updated clinical recommendations of authoritative medical societies on the discussing problem. There is detailed discussion of risk factors of atrial fibrillation onset in setting of hypertrophic cardiomyopathy with demonstration of results of different studies concerning to investigation of relationship between risk factors and probability of the arrhythmia development. There is description of detection methods, clinical manifestations, and the course of atrial fibrillation in patients with hypertrophic cardiomyopathy. The contemporary literature data are presented regarding to the management of patients with atrial fibrillation with use of anticoagulants, antiarrhythmic drugs, indications for performing of radiofrequency ablation and results of studies concerning long-term efficacy of such procedure are demonstrated. The discussion on the management of the patients in cases of sinus rhythm restoration or maintenance failure is described.

scholarly journals 0362: Atrial fibrillation after radiofrequency ablation of atrial flutter: prevalence and risk factors

2016 ◽  
Vol 8 (1) ◽  
pp. 69-70
Author(s):  
Mathias Guinot ◽  
François Lesaffre ◽  
Pierre Nazeyrollas ◽  
Karine Bauley ◽  
Jean-Pierre Chabert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Atrial Flutter

scholarly journals Radiofrequency Ablation versus Cryoablation in the Treatment of Paroxysmal Atrial Fibrillation: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Ali H. Hachem ◽  
Joseph E. Marine ◽  
Housam A. Tahboub ◽  
Sana Kamdar ◽  
Shaffi Kanjwal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Meta Analysis ◽  
Fluoroscopy Time ◽  
Radiofrequency Energy ◽  
Cryoballoon Ablation ◽  
Complication Rates ◽  
Ablation Time ◽  
Significant Difference

Background. Pulmonary vein isolation is commonly performed using radiofrequency energy with cryoablation gaining acceptance. We performed a meta-analysis of randomized controlled trials which compared radiofrequency versus cryoablation for patients with atrial fibrillation. Methods. A systematic search strategy identified both published and unpublished articles from inception to November 10, 2016, in multiple databases. The primary outcomes for this meta-analysis were long-term freedom from atrial fibrillation at 12-month follow-up and overall postoperative complication rates. For all included studies, the methodological quality was assessed through the Cochrane Collaboration’s tool for risk of bias. Results. A total of 247 articles were identified with eight being included in this review as they satisfied the prespecified inclusion criteria. Overall, there was no significant difference in freedom from atrial fibrillation at ≥12-month follow-up between those receiving cryoballoon and radiofrequency ablation, respectively (OR = 0.98, CI = 0.67–1.43, I2 = 56%, p=0.90). Additionally, the secondary outcomes of duration of ablation, fluoroscopy time, and ablation time failed to reach significance. Cryoballoon ablation had significantly greater odds of postoperative phrenic nerve injury at 12-month follow-up. Conclusions. Our meta-analysis suggests that cryoballoon ablation provides comparable benefits with regard to freedom from atrial fibrillation at medium-term follow-up, fluoroscopy time, ablation time, operative duration, and overall complication rate in comparison to radiofrequency ablation.

Abstract 16704: Leukocyte Telomere Length and Risk of Stroke: The Strong Heart Family Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Caroline Goode ◽  
Jinying Zhao ◽  
Richard B Devereux ◽  
Santosh Murthy ◽  
Alexander E Merkler ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Telomere Length ◽  
Family Study ◽  
Leukocyte Telomere Length ◽  
Potential Biomarker ◽  
Primary Model ◽  
Strong Heart Family Study

Introduction: Leukocyte telomere length (LTL) is a potential biomarker of aging and associated with several age-related diseases. Current research on an association between LTL and incident stroke has had inconclusive results. We hypothesized that LTL is associated with incident stroke among American Indians (AI) in the Strong Heart Family Study (SHFS). Methods: The SHFS is a population-based cohort study of cardiovascular disease (CVD) and its risk factors. Participants (n=2,769) recruited from regions in Arizona, Oklahoma and the Dakotas were assessed for LTL and CVD risk factors during a clinic visit between 2001 and 2003. Incident stroke events were identified through the end of 2018 (mean follow-up: 16.4 years). We assessed the association between LTL and incident stroke using frailty models based on the proportional hazards, accounting for family relatedness and established stroke risk factors that include sex, geographical location, education, smoking, atrial fibrillation, diabetes mellitus, and hypertension. Results: Among 2,769 participants, the mean age was 40.6±17.2 and 41.4% were male. During follow-up, there were 79 (2.9%) incident stroke cases. In the primary model, which adjusted for demographic variables (sex, location and education), the hazard ratios (HR) for stroke in participants in the first and second LTL quartiles were significantly higher than those in the highest (longest) LTL quartile, with HRs of 3.1 (95%CI: 1.4 - 6.6) and 3.5 (95%CI: 1.7 - 7.5), respectively. After adjusting for smoking, atrial fibrillation, diabetes mellitus, and hypertension, the association between LTL and stroke was attenuated, but remained significant when comparing the second shortest LTL quartile to the longest LTL quartile, HR: 2.3 (95% CI: 1.1 – 5.0). Conclusions: In summary, LTL was associated with incident stroke among SHFS participants. Those with shorter LTL have higher risk of stroke. Longer follow-up time may add more power to data analyses since the SHFS is relatively young, with an average baseline age of 40 years. If results are confirmed in other populations, LTL may serve as a biomarker identifying high risk individuals for the purpose of stroke prevention.

Abstract 360: Neighborhood-level Poverty and Incident Atrial Fibrillation: Analysis of Electronic Health Records From 2005-2018

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Utibe R Essien ◽  
Megan McCabe ◽  
Sadiya S Khan
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Census Tract ◽  
Individual Level ◽  
Neighborhood Poverty ◽  
Cardiovascular Morbidity And Mortality ◽  
Race Ethnicity ◽  
Neighborhood Level

Introduction: Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality. Disparities in AF outcomes have been related to individual-level social determinants of health, including race/ethnicity and socioeconomic status. While neighborhood-level factors, such as poverty, have been related to prevalence of key risk factors (e.g. obesity, hypertension), the association between neighborhood poverty and incident AF has not been previously examined. Methods: Using the Northwestern Medicine Enterprise Data Warehouse, we identified adults free of cardiovascular disease, with at least 5 years of follow-up from January 1, 2005 - December 31, 2013. Residential addresses were geocoded and matched to census tract level poverty estimates from the American Community Survey. Neighborhood poverty was defined as the proportion of residents in the census tract living below the US-defined poverty threshold. We categorized neighborhood poverty levels into tertiles. Generalized linear mixed effects models were used to examine the association between tertiles of neighborhood poverty and incident AF, adjusting for demographic (age, sex, race/ethnicity, insurance type) and AF risk factors (hypertension, diabetes, obesity and smoking status). Results: The cohort comprised 29,069 adults with a mean (SD) age of 51.4 (11.3) years, which included 58% women and 10% non-Hispanic Blacks. Higher rates of obesity, diabetes, hypertension, and smoking were observed in higher poverty groups. Approximately, 3.4% of patients developed incident AF over a follow-up of 5 years. The adjusted odds of incident AF were higher for the medium poverty compared to the low poverty group (adjusted odds ratio, aOR 1.30 (95% CI 1.05-1.56). The aOR of incident AF was similarly higher in the high poverty compared to low poverty group though not statistically significant (Table). Conclusions: In a cohort of adults free of cardiovascular disease at baseline, we found that residence in a more deprived neighborhood was associated with higher rates of incident AF, even after adjustment for traditional risk factors. Understanding how neighborhood and individual-level clinical factors interact to increase the incidence of AF is critical to developing equitable prevention strategies in this increasingly common condition.

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