title: Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation.
abstract: Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence.
  
  
  
  A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and ≥ 783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF ≥ 1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (≥ 783 SVEC: HR 4.6 [1.9-11.5], P < 0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence < 90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC ≥ 213: HR 3.0 [1.3-6.7], P = 0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period.
  
  
  
  Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.
authors.affiliation: Herlev-Gentofte University Hospital, Kildegaardsvej 28, 2900 Hellerup, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Alhede
authors.affiliation: Herlev-Gentofte University Hospital, Kildegaardsvej 28, 2900 Hellerup, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Johannessen
authors.affiliation: Hvidovre Hospital, Kettegaards Alle 30, 2650, Hvidovre, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Dixen
authors.affiliation: Herlev-Gentofte University Hospital, Kildegaardsvej 28, 2900 Hellerup, Denmark.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
authors.affiliation: Helsinki University Hospital, Haartmaninkatu 3, PO Box 180, 00029, Helsinki, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Raatikainen
authors.affiliation: Leipzig University Hospital, Leipzig, Augustusplatz 10, 04109, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Linkoping University Hospital, 581 85, Linkoping, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Walfridsson
authors.affiliation: Lund University Hospital, Getingevägen 4, 222 41, Lund, Sweden.
authors.forename: Ole
authors.initials: O
authors.lastname: Kongstad
authors.affiliation: Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Pehrson
authors.affiliation: Orebro University Hospital, Södra Grev Rosengatan, 701 85 Orebro, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Englund
authors.affiliation: Kupio University Hospital, Puijonlaaksontie 2, 70210 Kupio, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Hartikainen
authors.affiliation: Varde Heart Center, Hjertensvej 1, 6800 Varde, Denmark.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hansen
authors.affiliation: Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus, Denmark.
authors.forename: Jens C
authors.initials: JC
authors.lastname: Nielsen
authors.affiliation: Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Jons
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018880:Atrial Premature Complexes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Arrhythmia; Atrial fibrillation; Atrial premature complexes; Recurrence; Treatment