Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients
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Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients. / Pecha, Simon; Aydin, Muhammet Ali; Ahmadzade, Teymour; Hartel, Friederike; Hoffmann, Boris; Steven, Daniel; Willems, Stephan; Reichenspurner, Hermann; Wagner, Florian Mathias.
in: HEART VESSELS, Jahrgang 31, Nr. 8, 08.2016, S. 1347-1353.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients
AU - Pecha, Simon
AU - Aydin, Muhammet Ali
AU - Ahmadzade, Teymour
AU - Hartel, Friederike
AU - Hoffmann, Boris
AU - Steven, Daniel
AU - Willems, Stephan
AU - Reichenspurner, Hermann
AU - Wagner, Florian Mathias
PY - 2016/8
Y1 - 2016/8
N2 - Different follow-up methods have been used to report success rates after AF ablation. Recent studies have shown that intermittent rhythm monitoring underestimates the actual AF recurrence rate. We therefore report our experience with continuous rhythm monitoring by implantable loop recorder (ILR) in a large patient cohort. Between 09/2008 and 12/2012, 343 cardiac surgical patients underwent concomitant surgical AF ablation. ILR implantation was performed in 206 patients. ILR interrogation was accomplished at 3, 6 and 12 months postoperatively. Successful ablation was defined as AF Burden <0.5 %. Primary outcome of the study was freedom from AF at 12-month follow-up. Mean patient's age was 70.5 ± 7.4 years. No major ablation- or ILR-related complications occurred. In 4 patients (1.9 %) ILR had to be explanted due to ILR-related wound infection (n = 2) or chronic pain (n = 2). Survival rate at 1-year follow-up was 96.6 %. Freedom from AF rate after 1-year follow-up was 68.5 and 63.6 % off antiarrhythmic drugs, respectively. Statistically significant predictors for successful ablation at 1-year follow-up were smaller LA diameter, shorter duration of AF and preoperative paroxysmal AF. Demographic data, indication for surgery, lesion set and used energy source had no impact on freedom from AF after 1 year. Continuous ILR monitoring after concomitant surgical AF ablation was safe and feasible, with registered freedom from AF rate of 68.5 % at 1-year follow-up. Thus continuous rhythm monitoring provides reliable outcome data and helps to guide antiarrhythmic therapy.
AB - Different follow-up methods have been used to report success rates after AF ablation. Recent studies have shown that intermittent rhythm monitoring underestimates the actual AF recurrence rate. We therefore report our experience with continuous rhythm monitoring by implantable loop recorder (ILR) in a large patient cohort. Between 09/2008 and 12/2012, 343 cardiac surgical patients underwent concomitant surgical AF ablation. ILR implantation was performed in 206 patients. ILR interrogation was accomplished at 3, 6 and 12 months postoperatively. Successful ablation was defined as AF Burden <0.5 %. Primary outcome of the study was freedom from AF at 12-month follow-up. Mean patient's age was 70.5 ± 7.4 years. No major ablation- or ILR-related complications occurred. In 4 patients (1.9 %) ILR had to be explanted due to ILR-related wound infection (n = 2) or chronic pain (n = 2). Survival rate at 1-year follow-up was 96.6 %. Freedom from AF rate after 1-year follow-up was 68.5 and 63.6 % off antiarrhythmic drugs, respectively. Statistically significant predictors for successful ablation at 1-year follow-up were smaller LA diameter, shorter duration of AF and preoperative paroxysmal AF. Demographic data, indication for surgery, lesion set and used energy source had no impact on freedom from AF after 1 year. Continuous ILR monitoring after concomitant surgical AF ablation was safe and feasible, with registered freedom from AF rate of 68.5 % at 1-year follow-up. Thus continuous rhythm monitoring provides reliable outcome data and helps to guide antiarrhythmic therapy.
KW - Aged
KW - Atrial Fibrillation/surgery
KW - Cardiac Surgical Procedures
KW - Catheter Ablation
KW - Electrocardiography, Ambulatory/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Recurrence
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s00380-015-0735-4
DO - 10.1007/s00380-015-0735-4
M3 - SCORING: Journal article
C2 - 26319443
VL - 31
SP - 1347
EP - 1353
JO - HEART VESSELS
JF - HEART VESSELS
SN - 0910-8327
IS - 8
ER -