The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation

Christina Alhede; Trine K. Lauridsen; Arne Johannessen; Ulrik Dixen; Jan S. Jensen; Pekka Raatikainen; Gerhard Hindricks; Haakan Walfridsson; Ole Kongstad; Steen Pehrson; Anders Englund; Juha Hartikainen; Peter S. Hansen; Jens C. Nielsen; Christian Jons

doi:10.1016/j.ijcard.2017.09.208

The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation

Christina Alhede^*, Trine K. Lauridsen, Arne Johannessen, Ulrik Dixen, Jan S. Jensen, Pekka Raatikainen, Gerhard Hindricks, Haakan Walfridsson, Ole Kongstad, Steen Pehrson, Anders Englund, Juha Hartikainen, Peter S. Hansen, Jens C. Nielsen, Christian Jons

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

5 Citationer (Scopus)

Abstract

Introduction Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients ± 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods In total, 260 patients with LVEF > 40% and age ≤ 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age ± 57 years. We used multivariate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile > 195 SVEC/day. AF recurrence was defined as AF ≥ 1 min, AF-related cardioversion or hospitalization. Results Age > 57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients > 57 years which was not observed in the younger age group treated with CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (> 57 years: HR 3.4 [1.4–7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiology
Vol/bind	250
Sider (fra-til)	122-127
Antal sider	6
ISSN	0167-5273
DOI	https://doi.org/10.1016/j.ijcard.2017.09.208
Status	Udgivet - 2018

Adgang til dokumentet

10.1016/j.ijcard.2017.09.208

Citationsformater

Alhede, C., Lauridsen, T. K., Johannessen, A., Dixen, U., Jensen, J. S., Raatikainen, P., Hindricks, G., Walfridsson, H., Kongstad, O., Pehrson, S., Englund, A., Hartikainen, J., Hansen, P. S., Nielsen, J. C., & Jons, C. (2018). The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation. International Journal of Cardiology, 250, 122-127. https://doi.org/10.1016/j.ijcard.2017.09.208

The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation. / Alhede, Christina; Lauridsen, Trine K.; Johannessen, Arne et al.

I: International Journal of Cardiology, Bind 250, 2018, s. 122-127.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Alhede, C, Lauridsen, TK, Johannessen, A, Dixen, U, Jensen, JS, Raatikainen, P, Hindricks, G, Walfridsson, H, Kongstad, O, Pehrson, S, Englund, A, Hartikainen, J, Hansen, PS, Nielsen, JC & Jons, C 2018, 'The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation', International Journal of Cardiology, bind 250, s. 122-127. https://doi.org/10.1016/j.ijcard.2017.09.208

@article{3c453cfc6ee24da48149c0fdda8282f1,

title = "The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation",

abstract = "Introduction Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients ± 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods In total, 260 patients with LVEF > 40% and age ≤ 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age ± 57 years. We used multivariate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile > 195 SVEC/day. AF recurrence was defined as AF ≥ 1 min, AF-related cardioversion or hospitalization. Results Age > 57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients > 57 years which was not observed in the younger age group treated with CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (> 57 years: HR 3.4 [1.4–7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients.",

keywords = "Age, Arrhythmia, Premature ectopic beats, Recurrence, Treatment",

author = "Christina Alhede and Lauridsen, {Trine K.} and Arne Johannessen and Ulrik Dixen and Jensen, {Jan S.} and Pekka Raatikainen and Gerhard Hindricks and Haakan Walfridsson and Ole Kongstad and Steen Pehrson and Anders Englund and Juha Hartikainen and Hansen, {Peter S.} and Nielsen, {Jens C.} and Christian Jons",

year = "2018",

doi = "10.1016/j.ijcard.2017.09.208",

language = "English",

volume = "250",

pages = "122--127",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation

AU - Alhede, Christina

AU - Lauridsen, Trine K.

AU - Johannessen, Arne

AU - Dixen, Ulrik

AU - Jensen, Jan S.

AU - Raatikainen, Pekka

AU - Hindricks, Gerhard

AU - Walfridsson, Haakan

AU - Kongstad, Ole

AU - Pehrson, Steen

AU - Englund, Anders

AU - Hartikainen, Juha

AU - Hansen, Peter S.

AU - Nielsen, Jens C.

AU - Jons, Christian

PY - 2018

Y1 - 2018

N2 - Introduction Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients ± 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods In total, 260 patients with LVEF > 40% and age ≤ 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age ± 57 years. We used multivariate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile > 195 SVEC/day. AF recurrence was defined as AF ≥ 1 min, AF-related cardioversion or hospitalization. Results Age > 57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients > 57 years which was not observed in the younger age group treated with CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (> 57 years: HR 3.4 [1.4–7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients.

AB - Introduction Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients ± 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods In total, 260 patients with LVEF > 40% and age ≤ 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age ± 57 years. We used multivariate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile > 195 SVEC/day. AF recurrence was defined as AF ≥ 1 min, AF-related cardioversion or hospitalization. Results Age > 57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients > 57 years which was not observed in the younger age group treated with CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (> 57 years: HR 3.4 [1.4–7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients.

KW - Age

KW - Arrhythmia

KW - Premature ectopic beats

KW - Recurrence

KW - Treatment

U2 - 10.1016/j.ijcard.2017.09.208

DO - 10.1016/j.ijcard.2017.09.208

M3 - Journal article

C2 - 29050922

AN - SCOPUS:85031489505

SN - 0167-5273

VL - 250

SP - 122

EP - 127

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation

Abstract

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