TY - JOUR
T1 - Prevalence of atrial fibrillation and procedural outcome in patients undergoing catheter ablation for premature ventricular complexes
AU - Zou, Fengwei
AU - Di Biase, Luigi
AU - Mohanty, Sanghamitra
AU - Zhang, Xiaodong
AU - Shetty, Sai Shishir
AU - Gianni, Carola
AU - Della Rocca, Domenico G.
AU - Lin, Aung
AU - Arosio, Roberto
AU - Schiavone, Marco
AU - Forleo, Giovanni
AU - Mayedo, Angel
AU - MacDonald, Bryan
AU - Al-Ahmad, Amin
AU - Bassiouny, Mohamed
AU - Gallinghouse, G. Joseph
AU - Horton, Rodney
AU - Burkhardt, John D.
AU - Natale, Andrea
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2023/1
Y1 - 2023/1
N2 - Introduction: Atrial fibrillation (AF) and premature ventricular complexes (PVC) are common arrhythmias. We aimed to investigate AF prevalence in patients with PVC and its impact on PVC ablation outcomes. Methods: Consecutive patients undergoing PVC ablation at a single institution between 2016 and 2019 were included and prospectively followed for 2 years. Patients with severe valvular heart disease, hyperthyroidism, malignancy, alcohol use disorder and advanced renal/hepatic diseases were excluded. Twelve-lead electrocardiograms were used to diagnose AF and assess PVC morphology. All PVCs were targeted for ablation using 4-mm irrigated-tip catheters at standardized radiofrequency power guided by 3-D mapping and intracardiac echocardiography. Patients were followed with remote monitoring, device interrogations and office visits every 6 months for 2 years. Detection of any PVCs in follow-up was considered as recurrence. Results: A total of 394 patients underwent PVC ablation and 96 (24%) had concurrent AF. Patients with PVC and AF were significantly older (68.2 ± 10.8 vs. 58.3 ± 15.8 years, p <.001), had lower LV ejection fraction (43.3 ± 13.3% vs. 49.6 ± 12.4%, p <.001), higher CHA2DS2-VASc (2.8 ± 1.3 vs. 2.0 ± 1.3, p <.001) than those without. PVCs with ≥2 morphologies were detected in 60.4% and 13.7% patients with vs without AF (p <.001). At 2-year follow-up, PVC recurrence rate was significantly higher in patients with vs without AF (17.7% vs. 9.4%, p =.02). Conclusion: AF was documented in 1/4 of patients undergoing PVC ablation and was associated with lower procedural success at long-term follow-up. This was likely attributed to older age, worse LV function and higher prevalence of multiple PVC morphologies in patients with concurrent AF.
AB - Introduction: Atrial fibrillation (AF) and premature ventricular complexes (PVC) are common arrhythmias. We aimed to investigate AF prevalence in patients with PVC and its impact on PVC ablation outcomes. Methods: Consecutive patients undergoing PVC ablation at a single institution between 2016 and 2019 were included and prospectively followed for 2 years. Patients with severe valvular heart disease, hyperthyroidism, malignancy, alcohol use disorder and advanced renal/hepatic diseases were excluded. Twelve-lead electrocardiograms were used to diagnose AF and assess PVC morphology. All PVCs were targeted for ablation using 4-mm irrigated-tip catheters at standardized radiofrequency power guided by 3-D mapping and intracardiac echocardiography. Patients were followed with remote monitoring, device interrogations and office visits every 6 months for 2 years. Detection of any PVCs in follow-up was considered as recurrence. Results: A total of 394 patients underwent PVC ablation and 96 (24%) had concurrent AF. Patients with PVC and AF were significantly older (68.2 ± 10.8 vs. 58.3 ± 15.8 years, p <.001), had lower LV ejection fraction (43.3 ± 13.3% vs. 49.6 ± 12.4%, p <.001), higher CHA2DS2-VASc (2.8 ± 1.3 vs. 2.0 ± 1.3, p <.001) than those without. PVCs with ≥2 morphologies were detected in 60.4% and 13.7% patients with vs without AF (p <.001). At 2-year follow-up, PVC recurrence rate was significantly higher in patients with vs without AF (17.7% vs. 9.4%, p =.02). Conclusion: AF was documented in 1/4 of patients undergoing PVC ablation and was associated with lower procedural success at long-term follow-up. This was likely attributed to older age, worse LV function and higher prevalence of multiple PVC morphologies in patients with concurrent AF.
KW - atrial fibrillation
KW - catheter ablation
KW - premature ventricular complex
KW - premature ventricular complex recurrence
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U2 - 10.1111/jce.15749
DO - 10.1111/jce.15749
M3 - Article
C2 - 36378783
AN - SCOPUS:85142622158
SN - 1045-3873
VL - 34
SP - 147
EP - 152
JO - Journal of cardiovascular electrophysiology
JF - Journal of cardiovascular electrophysiology
IS - 1
ER -
