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Multicenter Study
. 2024 Jun;67(4):751-758.
doi: 10.1007/s10840-023-01654-1. Epub 2023 Oct 3.

Atrial fibrillation cycle-length (AF-CL) inside the pulmonary veins predicts paroxysmal AF ablation success- the INDUCE-AF study

Marco Bergonti  1   2 , Ciro Ascione  3   4 , Paolo Compagnucci  5 , Lorenzo Marcon  6 , Olivier Van Leuven  6 , Johan Saenen  6 , Wim Huybrechts  6 , Hielko Miljoen  6 , Michela Casella  5 , Yari Valeri  5 , Pierre Jaïs  3   4 , Frederic Sacher  3   4 , Hein Heidbuchel  6   7 , Andrea Sarkozy  6   8
Affiliations
Multicenter Study

Atrial fibrillation cycle-length (AF-CL) inside the pulmonary veins predicts paroxysmal AF ablation success- the INDUCE-AF study

Marco Bergonti et al. J Interv Card Electrophysiol. 2024 Jun.

Abstract

Background: A novel method to measure atrial fibrillation cycle length (AF-CL) was recently described, based on the average of 10 consecutive signals (FARS10). FARS10 accurately identified pulmonary vein isolation (PVI)-responders among patients with persistent AF. Whether this method is applicable to patients with paroxysmal AF is unknown.

Objective: The aim of this study is to evaluate the prognostic value of FARS10 measurements in patients with paroxysmal AF.

Methods and results: We enrolled paroxysmal AF patients undergoing PVI in a prospective multicenter study. After AF induction with a standardized protocol, the AF-CL was measured using FARS-10 method. The primary endpoint was AF/AT-recurrence. One-hundred and four patients were included (61 ± 14 years, 25% females). After a mean follow-up of 12 ± 4 months, AF/AT recurrence rate was 20%. The fastest PV CL (fPV-CL) was independently associated with the primary endpoint at multivariate analysis (HR 1.02, p < 0.001). Every 10 ms increase in fPV-CL, AF recurrences increased by 20%. The value of 160 ms was found to be the optimal cut-off (specificity 81%, sensitivity 76%). Patients with fPV-CL < 160 ms experienced lower AF recurrences as compared to patients with fPV-CL > 160 ms (8% vs. 32% at 1 year; HR = 0.17, p < 0.001). Progression to persistent AF was observed in 13% of patients with fPV-CL > 160 ms.

Conclusion: fPV-CL measured with the FARS-10 method accurately predicts PVI success in paroxysmal AF patients undergoing PVI. Patients with slow PV activity (fPV-CL > 160 ms) experience higher AF recurrence rate after PVI and more frequent progression to persistent AF.

Keywords: Atrial fibrillation; Cycle length; Paroxysmal; Pulmonary vein activity; Pulmonary vein isolation; Responder.

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References

    1. Calkins H, Hindricks G, Cappato R, Kim Y-H, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen P-S, Chen S-A, Chung MK, Cosedis Nielsen J, Curtis AB, Davies DW, Day JD, d’Avila A, Natasja de Groot NMS, Di BL, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Eur Eur pacing, Arrhythmias, Card Electrophysiol J Work Groups Card Pacing, Arrhythmias, Card Cell Electrophysiol Eur Soc Cardiol. 2018;20:e1–160.
    1. Glikson M, Wolff R, Hindricks G, Mandrola J, Camm AJ, Lip GYH, Fauchier L, Betts TR, Lewalter T, Saw J, Tzikas A, Sternik L, Nietlispach F, Berti S, Sievert H, Bertog S, Meier B. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion - an update. EP Eur England. 2020;22:184.
    1. Andrade JG, Wells GA, Deyell MW, Bennett M, Essebag V, Champagne J, Roux JF, Yung D, Skanes A, Khaykin Y, Morillo C, Jolly U, Novak P, Lockwood E, Amit G, Angaran P, Sapp J, Wardell S, Lauck S, Macle L, Verma A; EARLY-AF Investigators. Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. N Engl J Med. 2021;384(4):305–15. https://doi.org/10.1056/NEJMoa2029980 .
    1. Bottoni N, Quartieri F, Iori M, Battista A, Navazio A, Brignole M. Twenty-year experience of atrial fibrillation ablation: a single-centre cohort study. Europace. 2023;25(5):euad069. https://doi.org/10.1093/europace/euad069 .
    1. Sørensen SK, Johannessen A, Worck R, Hansen ML, Hansen J. Radiofrequency versus cryoballoon catheter ablation for paroxysmal atrial fibrillation: durability of pulmonary vein isolation and effect on atrial fibrillation burden: The RACE-AF Randomized Controlled Trial. Circ Arrhythm Electrophysiol. 2021;14(5):e009573. https://doi.org/10.1161/CIRCEP.120.009573 .

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