Clinical Implications of Various Follow up
Strategies after Catheter Ablation of Atrial
Fibrillation
Arash ARYA, M.D., Gerhard HINDRICKS, M.D., Christopher PIORPOWSKI, M.D.,
Jin-hong GERDS-LI, M.D., Christian GERDES, M.D., Philip SOMMER, M.D.,
Hans KOTTKAMP, M.D.
University of Leipzig, Heart Center, Leipzig, Germany
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Ablation
Method
Study
During the follow-up period, 89% of patients
remained free of arrhythmia.
SPVA†/CPVA
Freedom from AF in RQH 7-day Holter 6 months
after catheter ablation.
During the follow-up period, 27 patients (54%) after
CPVA and 41 patients (82%) after SPVA remained
free of arrhythmia-related symptoms.
CPVA
Repetitive 7-day Holter before and after ablation
was used for rhythm follow-up.
Freedom from AF after 12 months of follow up was
88% or 74% depending on whether 1-day or 7-day
Holter monitoring were used.
CPVA
ECG and Holter recordings one and four months
after ablation, as well as a daily TT ECG, from 30
to 120 days after ablation or symptom
Transtelephonic ECG is better than standard ECG
and 24-h Holter recordings in evaluating AF relapses
after RCA, thus decreasing the short-term success
of ablation from 86% to 72%.
CPVA/SPVA
Patients were instructed to report V\PSWRPV
suggestive of PAF and were provided with an
event recorder to document the cause of their
V\PSWRPV.
At 6 months, 67% of patients who underwent SOCA
and 88% of patients who underwent LACA were free
of symptomatic recurrence of AF.
SPVA
When the patients experienced symptoms
suggestive of AF, 24-hour Holter monitoring or
cardiac event recording was performed to define
the cause of the clinical V\PSWRPV.
Among 293 patients, 104 patients (35%) had
recurrences of V\PSWRPDWLF AF after the first ablation
procedure.
SPVA±CEA‡
The patients were followed every 3 months after
the procedure (24hr. ECG). Patients were provided
with an auto triggered event monitor to document
the nature of their symptoms.
A repeat ablation procedure was performed in 18%
of patients. During a mean follow-up of 11±4 months,
77% of patients were free from AF and/or atrial flutter
without antiarrhythmic therapy.
CPVA
TT ECG once every 2 days for half a year.
Additionally, a 7-day Holter was recorded
preablation, after ablation, after 3 and 6 months
of follow up.
The success rate in terms of freedom from AF was
70% on a symptom-only-based follow up; using
serial 7-day Holter it decreased to 50% and on TT
monitoring to 45%, respectively.
Outpatient telemetry. 5 days immediately before
the ablation, and 5 days per month starting with
the ablation for 6 months.
At the end of the follow-up, 70% of the patients were
free of V\PSWRPDWLF AF recurrences whereas only
50% patients achieved success when DV\PSWRPDWLF
AF recurrences were included in the outcome.
CPVA*
Karch 30
Kottkamp 22
Oral
29
Hsieh
31
Oral 23
Piorkowski
11
Vasamreddy
14
Success Rate
Four TT ECG** per day and 48-hour Holter
recordings before and 1 week after CPVA and
once PRQWKO\ until follow-up ended at 12 months.
Pappone 28
Senatore 24
Follow Up Strategy
SPVA+CTIA§
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Clinical Implications of Various Follow up Strategies