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Comparison of the origin and coupling interval between ectopy with and without atrial fibrillation initiation.
- Source :
-
Journal of cardiology [J Cardiol] 2018 Jan; Vol. 71 (1), pp. 59-64. Date of Electronic Publication: 2017 Jul 13. - Publication Year :
- 2018
-
Abstract
- Background: Differentiation of atrial fibrillation (AF) trigger ectopy from other ectopy is often difficult. The purpose of this study was to compare the origin and coupling intervals (CI) between AF-trigger and non-AF-trigger ectopy.<br />Methods: This study consisted of 120 patients with AF who underwent an initial ablation. Isoproterenol was infused up to 20μg/min to provoke ectopy and AF. We measured the CI of all ectopy provoked by an isoproterenol infusion. The %CI was calculated as the CI of the ectopy/P-P interval of the preceding 2 beats.<br />Results: A total of 117 patients had at least one ectopy, and AF was induced in 56 (47%) patients. Of the 276 ectopies observed in this study, 211 (76%) originated from pulmonary veins and 77 (28%) were AF-trigger ectopy. AF-trigger ectopy more frequently originated from pulmonary veins (PVs) (74 vs. 3, p<0.001) and had a significantly shorter CI (201±70ms vs. 365±147ms, p<0.001) and lower %CI (29±11% vs. 55±14%, p<0.001) than that of non-AF-trigger ectopy. A receiver operating characteristics analysis revealed that a %CI of 40% was the best cut-off value for differentiating whether it was an AF-trigger or not. The identified trigger group, including patients with provoked AF-trigger ectopy or ectopy with a low %CI (<40%), had a significantly better AF recurrence-free survival rate than the other group (88% vs. 65%, p=0.004).<br />Conclusions: AF-trigger ectopy predominantly originated from PVs and had a short CI. These findings may be useful for estimating whether ectopies are an AF-trigger or not.<br /> (Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Atrial Fibrillation chemically induced
Atrial Fibrillation complications
Atrial Fibrillation surgery
Cardiac Complexes, Premature etiology
Cardiotonic Agents
Catheter Ablation
Female
Humans
Isoproterenol
Male
Middle Aged
Pulmonary Veins surgery
Treatment Outcome
Atrial Fibrillation physiopathology
Cardiac Complexes, Premature physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4738
- Volume :
- 71
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 28712522
- Full Text :
- https://doi.org/10.1016/j.jjcc.2017.06.002