Skip Navigation


European Heart Journal Advance Access originally published online on February 9, 2008
European Heart Journal 2008 29(8):1037-1042; doi:10.1093/eurheartj/ehn024
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
29/8/1037    most recent
ehn024v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in EHJ
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (14)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Steven, D.
Right arrow Articles by Willems, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Steven, D.
Right arrow Articles by Willems, S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring

Daniel Steven*, Thomas Rostock, Boris Lutomsky, Hanno Klemm, Helge Servatius, Imke Drewitz, Kai Friedrichs, Rodolfo Ventura, Thomas Meinertz and Stephan Willems

Department of Cardiology, University Heart Centre Hamburg, Martinistr. 52, Hamburg 20246, Germany

Received 11 August 2007; revised 7 January 2008; accepted 10 January 2008; online publish-ahead-of-print 9 February 2008.

* Corresponding author. Tel: +49(0) 40 42803 4120, Fax: +49(0) 40 42803 4125, Email: d.steven{at}uke.uni-hamburg.de

See page 964 for the editorial comment on this article (doi:10.1093/eurheartj/ehn108)

Aims: Rhythm follow-up after catheter ablation of atrial fibrillation (AF ablation) is mainly based on Holter electrocardiogramm (ECG), tele-ECG or on patients symptoms. However, studies using 7-day Holter or tele-ECG follow-up revealed a significant number of asymptomatic recurrences. Thus, the aim of this study was to analyse continuous atrial recordings in pacemaker patients with an incorporated Holter function before and after AF ablation in order to determine all AF recurrences and thereby the ‘real’ success rates.

Methods and results: The study comprised 37 patients (64.6 ± 10 years) with prior pacemaker/implantable cardioverter defibrillator (ICD) implantation including an atrial Holter function referred for AF ablation. Holter data were obtained and correlated to patients’ symptoms before and every 3-month after AF ablation. AF recurrence was defined as an atrial high frequency episode of less than 330 ms (180 b.p.m.) lasting longer than 30 s. The ablation procedure consisted of pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF, n = 20) and additional substrate modification aiming arrhythmia termination in patients with persistent or inducible AF after PVI as well as in patients with a history of long-lasting persistent AF (PersAF, n = 17). The mean atrial Holter monitoring period was 7.4 ± 3.3 months before and 13.5 ± 4.2 months after ablation with an overall AF burden of 33.7% prior to ablation. During follow-up, AF burden decreased from 17.3–0.65% (P = 0.001) in PAF patients and from 57.4 to 13.9% (P = 0.024) in patients with PersAF. Complete AF freedom was observed in 85% (17 patients) of PAF patients and 59% (10 patients) in patients with PersAF. The absence of symptoms correlated well with documented freedom of AF.

Conclusion: In the present study we could show, that freedom from AF can be achieved by catheter ablation in a high percentage of patients even with PersAF. Continuous atrial monitoring reveals AF ablation success rates comparable with those assessed by clinical evaluation. Symptomatic freedom of AF correlated well with the actual freedom of AF at least in this highly symptomatic patient cohort.

Key Words: Atrial fibrillation • Ablation • Pacemaker • Atrial Holter recording


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Related articles in EHJ:

Atrial fibrillation burden: a ‘hard’ indicator of therapeutic efficacy and a prognostic marker to boot?
Dipen Shah
EHJ 2008 29: 964-965. [Extract] [FREE Full Text]  



This article has been cited by other articles:


Home page
 EuropaceHome page
G. Andrikopoulos, S. Tzeis, G. Theodorakis, and P. Vardas
Monitoring capabilities of cardiac rhythm management devices
Europace, October 29, 2009; (2009) eup317v1.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
R. H. Falk and A. J. Camm
Rethinking the reasons to treat atrial fibrillation? The role of dronedarone in reducing cardiovascular hospitalizations
Eur. Heart J., October 2, 2009; 30(20): 2438 - 2440.
[Full Text] [PDF]

Home page
 CirculationHome page
T. Hanke, E. I. Charitos, U. Stierle, A. Karluss, E. Kraatz, B. Graf, A. Hagemann, M. Misfeld, and H. H. Sievers
Twenty-Four-Hour Holter Monitor Follow-Up Does Not Provide Accurate Heart Rhythm Status After Surgical Atrial Fibrillation Ablation Therapy: Up to 12 Months Experience With a Novel Permanently Implantable Heart Rhythm Monitor Device
Circulation, September 15, 2009; 120(11_suppl_1): S177 - S184.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
E. Bertaglia, P. D. Bella, C. Tondo, A. Proclemer, N. Bottoni, R. De Ponti, M. Landolina, M. G. Bongiorni, L. Coro, G. Stabile, et al.
Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMergeTM Italian Registry
Europace, August 1, 2009; 11(8): 1004 - 1010.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Ad, L. Henry, S. Hunt, S. Barnett, and L. Stone
The Cox-Maze III procedure success rate: comparison by electrocardiogram, 24-hour holter monitoring and long-term monitoring.
Ann. Thorac. Surg., July 1, 2009; 88(1): 101 - 105.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
R.-B. Tang, J.-Z. Dong, X.-P. Liu, J.-P. Kang, S.-F. Ding, L. Wang, D.-Y. Long, R.-H. Yu, X.-H. Liu, S. Liu, et al.
Obstructive sleep apnoea risk profile and the risk of recurrence of atrial fibrillation after catheter ablation
Europace, January 1, 2009; 11(1): 100 - 105.
[Abstract] [Full Text] [PDF]

Home page
 ESC Textbook of Cardiovascular MedicineHome page
A. J. Camm, P. Kirchhof, G. Y.H. Lip, I. Savelieva, and S. Ernst
CHAPTER 29 Atrial Fibrillation
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]

Home page
 Circ Arrhythm ElectrophysiolHome page
T. Rostock, D. Steven, B. Hoffmann, H. Servatius, I. Drewitz, K. Sydow, K. Mullerleile, R. Ventura, K. Wegscheider, T. Meinertz, et al.
Chronic Atrial Fibrillation Is a Biatrial Arrhythmia: Data from Catheter Ablation of Chronic Atrial Fibrillation Aiming Arrhythmia Termination Using a Sequential Ablation Approach
Circ Arrhythm Electrophysiol, December 1, 2008; 1(5): 344 - 353.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
C. Martignani, I. Diemberger, M. Biffi, C. Valzania, M. Bertini, and G. Boriani
How to assess the efficacy of catheter ablation of atrial fibrillation?
Eur. Heart J., September 1, 2008; 29(17): 2183 - 2184.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
D. Steven and S. Willems
How to assess the efficacy of catheter ablation of atrial fibrillation: reply
Eur. Heart J., September 1, 2008; 29(17): 2184 - 2185.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
D. Shah
Atrial fibrillation burden: a 'hard' indicator of therapeutic efficacy and a prognostic marker to boot?
Eur. Heart J., April 2, 2008; 29(8): 964 - 965.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.