title: Effect of pulmonary vein isolation on atrial fibrillation recurrence after ablation of paroxysmal supraventricular tachycardia in patients with high dispersion of atrial refractoriness.
abstract: OBJECTIVE
  This study aimed to assess pulmonary vein isolation (PVI) efficacy on atrial fibrillation (AF) recurrence and to determine a predictive dispersion of atrial refractoriness (dERP) value for performing PVI in paroxysmal supraventricular tachycardia (PSVT) patients.
  
  
  METHODS
  Of 67 PSVT patients with past AF episodes who underwent accessory pathway (AP) or slow pathway of atrioventricular node ablation, 63 (4 lost to follow-up or death) were assigned into two groups (A and B; 29 and 34 patients, respectively) based on whether they underwent or not subsequent PVI, and all were followed-up up to 3 years. Atrial effective refractory period (AERP) and dERP were measured during the ablation procedure.
  
  
  RESULTS
  In receiver operating characteristic (ROC) curve analysis, dERP = 74.5 ms effectively predicted AF recurrence in PSVT patients (p = 0.003). Difference in AF recurrence rate between groups did not reach statistical significance (17.2%, 5/29 vs. 29.4%, 10/34, p = 0.203). AF recurrence rate was lower in patients with dERP >74.5 ms who underwent AP or slow-pathway ablation with vs. without PVI (18.2%, 2/11 vs. 77.8%, 7/9, p = 0.012).
  
  
  CONCLUSIONS
  PVI addition after successful AP or slow pathway of atrioventricular node ablation significantly reduced AF recurrence in PSVT patients with high atrial vulnerability (dERP >74.5 ms).
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Shandong, China.
authors.forename: Zhen-xing
authors.initials: ZX
authors.lastname: Xu
authors.forename: Jing-quan
authors.initials: JQ
authors.lastname: Zhong
authors.forename: Bing
authors.initials: B
authors.lastname: Rong
authors.forename: Xin
authors.initials: X
authors.lastname: Yue
authors.forename: Zhao-tong
authors.initials: ZT
authors.lastname: Zheng
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhu
authors.forename: Shao-lei
authors.initials: SL
authors.lastname: Yi
authors.forename: Jun-tao
authors.initials: JT
authors.lastname: Wang
authors.forename: Man
authors.initials: M
authors.lastname: Li
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000601:surgery*; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome