Early recurrence of atrial tachyarrhythmia indicates pulmonary vein reconduction independent of blanking period duration in the RACE‐AF trial

• Published in: Journal of cardiovascular electrophysiology 2023-12, Vol.34 (12), p.2434-2442
• Main Authors: Sørensen, Samuel K., Johannessen, Arne, Worck, René, Hansen, Morten L., Ruwald, Martin H., Hansen, Jim
• Format: Article
• Language: English
• Subjects: Atrial Fibrillation - diagnosis; Atrial Fibrillation - etiology; Atrial Fibrillation - surgery; blanking period; Catheter Ablation - adverse effects; Catheter Ablation - methods; Cryosurgery - adverse effects; Cryosurgery - methods; early recurrence; Heart Atria; Humans; implantable cardiac monitor; protocol‐mandated repeat procedure; pulmonary vein isolation; Pulmonary Veins - surgery; Recurrence; Tachyarrhythmia; Tachycardia; Treatment Outcome
• ISSN: 1045-3873; 1540-8167; 1540-8167
• DOI: 10.1111/jce.16098

Introduction Atrial tachyarrhythmia recurrence during the blanking period (early ATA) after pulmonary vein isolation (PVI) is associated with an increased risk of later recurrence, but its relationship with pulmonary vein reconduction (PVR) is poorly understood. The objective of the present study was to evaluate the relationship between early ATA and PVR. Second, to provide data on the optimal blanking period by (a) evaluating how the predictive values of ATA for PVR are affected by blanking period duration, and (b) assessing the temporal development in atrial fibrillation (AF) burden. Methods In this RACE‐AF substudy, 91 patients with paroxysmal AF undergoing PVI randomized to radiofrequency or cryoballoon ablation were included. All patients received an implantable cardiac monitor and underwent a protocol‐mandated repeat procedure after 4–6 months for assessment of PVR. ATA ≥ 30 s. ≤ 90 days after PVI constituted early ATA. Results PVR was found in 37/54 (69%) patients with early ATA and in 11/37 (30%) patients without (p