Asymptomatic recurrences of atrial fibrillation after pulmonary vein isolation.
OBJECTIVE
The purpose of this study was to determine the occurrence of asymptomatic episodes of atrial fibrillation (AF) and wrong AF perception after pulmonary vein isolation (PVI). We evaluated the success of ablation by using the following measurements: (i) clinical symptoms and duration of symptoms noticed by patients and (ii) synchronous event recording (ER).


RESULTS
Eighty patients with paroxysmal AF underwent PVI and were provided repeatedly with a portable ER upon discharge and every 3 months for a year. The ER automatically detects arrhythmias by a detection algorithm and can also be manually triggered by the patient. In 46/80 patients (57.5%), episodes of AF were documented. Asymptomatic AF was detected in 21.3%. In 9/80 patients (11.3%), who reported clinical AF recurrence, no AF could be shown by ER. We compared patients' perception to have suffered AF episodes with the ERs and found a sensitivity of 75% and a specificity of 92%.


CONCLUSIONS
Reliance on perception of AF by patients after PVI results in an underestimation of recurrence of the arrhythmia. We observed a maximal occurrence of silent AF or wrong perception of AF in 26/80 (32.6%) patients.
Neumann
Thomas
T
Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. tneuman1@aol.com
Erdogan
Ali
A
Dill
Thorsten
T
Greiss
Harald
H
Berkowitsch
Alexander
A
Sperzel
Johannes
J
Kuniss
Malte
M
Kurzidim
Klaus
K
Hamm
Christian W
CW
Pitschner
Heinz-Friedrich
HF
D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D018709:Statistics, Nonparametric; D016896:Treatment Outcome