Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843

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Burden and Long Firing of Premature Atrial Contraction Early After Catheter Ablation Predict Late Recurrence of Atrial Fibrillation
Hiroyuki InoueNobuaki TanakaKoji TanakaYuichi NinomiyaYuko HiraoTakafumi OkaMasato OkadaRyo KitagakiKohtaro TakayasuYasushi KoyamaAtsunori OkamuraKatsuomi IwakuraKenshi FujiiYasushi SakataKoichi Inoue
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論文ID: CJ-19-0976

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Background:Associations between characteristics of premature atrial contraction (PAC) 6 months after catheter ablation (CA) and later recurrence are not known. We investigated the effects of PAC characteristics on long-term outcomes of initially successful atrial fibrillation (AF) ablation.

Methods and Results:In all, 378 patients (mean age 61 years, 21% female, 67% paroxysmal AF) who underwent initial radiofrequency CA for AF without recurrence up to 24-h Holter monitoring 6 months after the procedure were reviewed retrospectively. The calculated number of PAC/24 h and the length of the longest PAC run during Holter recording were analyzed. After 4.3±1.2 years (mean±SD) follow-up, 123 (32.5%) patients experienced late recurrence. Patients with recurrence had significantly more PAC/24 h (median [interquartile range] 110 [33–228] vs. 42 [16–210]; P<0.01) and a longer longest PAC run (5 [2–8] vs. 3 [1–5]; P<0.01) than those without. Receiver operating characteristic curve analysis indicated 58 PAC/24 h and a longest PAC run of 5 were optimal cut-off values for predicting recurrence. After adjusting for previously reported predictors of late recurrence, frequent PAC (≥58/24 h) and longest PAC run ≥5 were found to be independent predictors of late recurrence (hazard ratios [95% confidence intervals] 1.93 [1.24–3.02; P<0.01] and 1.81 [1.20–2.76; P<0.01], respectively).

Conclusions:Six months after successful AF ablation, both frequent PAC and long PAC run are independent predictors of late recurrence.

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