Cited by 507Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

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Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation: Relevance of Asymptomatic Arrhythmia Recurrence

Hindricks, Gerhard, Piorkowski, Christopher, Tanner, Hildegard, Kobza, Richard, Gerds-Li, Jin-Hong, Carbucicchio, Corrado, Kottkamp, Hans·2005·Circulation

DOI 10.1161/circulationaha.104.518837

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Abstract

Background— The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. Methods and Results— In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70 000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% ( P <0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF. Conclusions— Even in patients presenting with highly symptomatic AF, asymptomatic episodes may occur and significantly increase after catheter ablation. A symptom-only–based follow-up would substantially overestimate the success rate. Objective measures such as long-term Holter monitoring are needed to identify asymptomatic AF recurrences after ablation.

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“For patients with documented AF, the median total arrhythmia duration during the 7-day ECG periods measured 38 (10, 133) hours before ablation and postinterventionally declined to 36 (22, 79) hours immediately after ablation (P 0.”
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Authors: Hindricks, G., Piorkowski, C., Tanner, H., Kobza, R., Gerds-Li, J.-H., Carbucicchio, C., & Kottkamp, H.
Affiliations: Leipzig University (DE)
From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany.
ORCID: Hindricks, Gerhard
Piorkowski, Christopher
Tanner, Hildegard
Kobza, Richard
Carbucicchio, Corrado
Kottkamp, Hans
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-07-19
Volume: 112
Issue: 3
Pages: 307-313
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.104.518837
OpenAlex: W1988904908
Cited by: 506
References: 14
Citations by year: 2026: 9 · 2025: 11 · 2024: 9 · 2023: 11 · 2022: 14 · 2021: 14 · 2020: 15 · 2019: 20 · 2018: 15 · 2017: 18 · 2016: 19 · 2015: 17 · 2014: 34 · 2013: 28 · 2012: 37
FWCI: 27.35
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords: atrial fibrillation, asymptomatic atrial fibrillation, radiofrequency catheter ablation, atrial fibrillation recurrence, Holter monitoring, pulmonary vein isolation, antiarrhythmic drug failure, long-term follow-up
MeSH terms: Adrenergic beta-Antagonists, Adult, Aged, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Prospective Studies, Recurrence, Catheter Ablation

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Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation: Relevance of Asymptomatic Arrhythmia Recurrence

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