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Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications

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Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications. / Erhard, Nico; Metzner, Andreas; Fink, Thomas.

In: Herzschrittmacherther Elektrophysiol, Vol. 33, No. 1, 03.2022, p. 71-76.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Erhard, N, Metzner, A & Fink, T 2022, 'Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications', Herzschrittmacherther Elektrophysiol, vol. 33, no. 1, pp. 71-76. https://doi.org/10.1007/s00399-021-00836-6

APA

Erhard, N., Metzner, A., & Fink, T. (2022). Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications. Herzschrittmacherther Elektrophysiol, 33(1), 71-76. https://doi.org/10.1007/s00399-021-00836-6

Vancouver

Erhard N, Metzner A, Fink T. Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications. Herzschrittmacherther Elektrophysiol. 2022 Mar;33(1):71-76. https://doi.org/10.1007/s00399-021-00836-6

Bibtex

@article{408df05f2bd742f3a8eb06ab2e4a62b2,
title = "Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications",
abstract = "BACKGROUND AND OBJECTIVES: Catheter ablation of atrial fibrillation (AF) has become a well-established and widely used therapy, with pulmonary vein isolation (PVI) being the key modality of ablation. However, arrhythmia recurrences after PVI are common, with a relevant number of patients undergoing repeat ablation. Arrhythmia recurrence after PVI may vary regarding time point and mode of recurrence. While early arrhythmia recurrences of AF after PVI are mostly found to be the product of electrical reconnection of the pulmonary veins, the exact mechanisms of very late arrhythmia recurrence, occurring later than 12 months after successful PVI, remain unclear. This review provides an overview on the current evidence on time point and mechanisms of arrhythmia recurrence after PVI focussing on late arrhythmia recurrence.RECENT FINDINGS: The incidence of late arrhythmia recurrence after PVI can lie at a rate of up to 30% according to long-term follow-up studies. Mechanisms of recurrence include electrical reconnection of previously isolated pulmonary veins and development of atrial fibrosis. The use of cryoballoon ablation is likely to be more effective in reducing late arrhythmia recurrences compared to radiofrequency ablation. Novel scores such as the MB-LATER score or the APPLE score may become useful tools in predicting arrhythmia recurrence after PVI.RESULTS AND CONCLUSION: Late arrhythmia recurrence after PVI is common and leads to a relevant impairment of long-term success. Relevant data are currently limited and exact mechanisms of arrhythmia recurrence remain unclear. Further studies are needed to elucidate pathogenetic mechanisms of late arrhythmia recurrence after PVI in order to improve treatment strategies.",
keywords = "Atrial Fibrillation/diagnosis, Catheter Ablation/methods, Humans, Incidence, Pulmonary Veins/surgery, Recurrence, Treatment Outcome",
author = "Nico Erhard and Andreas Metzner and Thomas Fink",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = mar,
doi = "10.1007/s00399-021-00836-6",
language = "English",
volume = "33",
pages = "71--76",
journal = "Herzschrittmacherther Elektrophysiol",
issn = "1435-1544",
publisher = "D. Steinkopff-Verlag",
number = "1",

}

RIS

TY - JOUR

T1 - Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications

AU - Erhard, Nico

AU - Metzner, Andreas

AU - Fink, Thomas

N1 - © 2022. The Author(s).

PY - 2022/3

Y1 - 2022/3

N2 - BACKGROUND AND OBJECTIVES: Catheter ablation of atrial fibrillation (AF) has become a well-established and widely used therapy, with pulmonary vein isolation (PVI) being the key modality of ablation. However, arrhythmia recurrences after PVI are common, with a relevant number of patients undergoing repeat ablation. Arrhythmia recurrence after PVI may vary regarding time point and mode of recurrence. While early arrhythmia recurrences of AF after PVI are mostly found to be the product of electrical reconnection of the pulmonary veins, the exact mechanisms of very late arrhythmia recurrence, occurring later than 12 months after successful PVI, remain unclear. This review provides an overview on the current evidence on time point and mechanisms of arrhythmia recurrence after PVI focussing on late arrhythmia recurrence.RECENT FINDINGS: The incidence of late arrhythmia recurrence after PVI can lie at a rate of up to 30% according to long-term follow-up studies. Mechanisms of recurrence include electrical reconnection of previously isolated pulmonary veins and development of atrial fibrosis. The use of cryoballoon ablation is likely to be more effective in reducing late arrhythmia recurrences compared to radiofrequency ablation. Novel scores such as the MB-LATER score or the APPLE score may become useful tools in predicting arrhythmia recurrence after PVI.RESULTS AND CONCLUSION: Late arrhythmia recurrence after PVI is common and leads to a relevant impairment of long-term success. Relevant data are currently limited and exact mechanisms of arrhythmia recurrence remain unclear. Further studies are needed to elucidate pathogenetic mechanisms of late arrhythmia recurrence after PVI in order to improve treatment strategies.

AB - BACKGROUND AND OBJECTIVES: Catheter ablation of atrial fibrillation (AF) has become a well-established and widely used therapy, with pulmonary vein isolation (PVI) being the key modality of ablation. However, arrhythmia recurrences after PVI are common, with a relevant number of patients undergoing repeat ablation. Arrhythmia recurrence after PVI may vary regarding time point and mode of recurrence. While early arrhythmia recurrences of AF after PVI are mostly found to be the product of electrical reconnection of the pulmonary veins, the exact mechanisms of very late arrhythmia recurrence, occurring later than 12 months after successful PVI, remain unclear. This review provides an overview on the current evidence on time point and mechanisms of arrhythmia recurrence after PVI focussing on late arrhythmia recurrence.RECENT FINDINGS: The incidence of late arrhythmia recurrence after PVI can lie at a rate of up to 30% according to long-term follow-up studies. Mechanisms of recurrence include electrical reconnection of previously isolated pulmonary veins and development of atrial fibrosis. The use of cryoballoon ablation is likely to be more effective in reducing late arrhythmia recurrences compared to radiofrequency ablation. Novel scores such as the MB-LATER score or the APPLE score may become useful tools in predicting arrhythmia recurrence after PVI.RESULTS AND CONCLUSION: Late arrhythmia recurrence after PVI is common and leads to a relevant impairment of long-term success. Relevant data are currently limited and exact mechanisms of arrhythmia recurrence remain unclear. Further studies are needed to elucidate pathogenetic mechanisms of late arrhythmia recurrence after PVI in order to improve treatment strategies.

KW - Atrial Fibrillation/diagnosis

KW - Catheter Ablation/methods

KW - Humans

KW - Incidence

KW - Pulmonary Veins/surgery

KW - Recurrence

KW - Treatment Outcome

U2 - 10.1007/s00399-021-00836-6

DO - 10.1007/s00399-021-00836-6

M3 - SCORING: Review article

C2 - 35006336

VL - 33

SP - 71

EP - 76

JO - Herzschrittmacherther Elektrophysiol

JF - Herzschrittmacherther Elektrophysiol

SN - 1435-1544

IS - 1

ER -