Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation

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.2017.05.028

Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation

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

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

BACKGROUND: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24months of follow-up.

METHODS: Patients with paroxysmal AF (N=260) enrolled in the MANTRA PAF trial were treated with AAD (N=132) or CA (N=128). At baseline and 3, 6, 12, 18 and 24months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test.

RESULTS: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p=0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24months of follow-up.

CONCLUSION: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.

Original language	English
Journal	International Journal of Cardiology
Volume	244
Pages (from-to)	186-191
Number of pages	6
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2017.05.028
Publication status	Published - 1 Oct 2017

Keywords

Adult
Aged
Anti-Arrhythmia Agents/therapeutic use
Atrial Fibrillation/epidemiology
Atrial Premature Complexes/epidemiology
Catheter Ablation/methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Treatment Outcome

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10.1016/j.ijcard.2017.05.028

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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. (2017). Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation. International Journal of Cardiology, 244, 186-191. https://doi.org/10.1016/j.ijcard.2017.05.028

Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation. / Alhede, Christina; Lauridsen, Trine K; Johannessen, Arne et al.
In: International Journal of Cardiology, Vol. 244, 01.10.2017, p. 186-191.

Research output: Contribution to journal › Journal article › Research › 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 2017, 'Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation', International Journal of Cardiology, vol. 244, pp. 186-191. https://doi.org/10.1016/j.ijcard.2017.05.028

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title = "Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation",

abstract = "BACKGROUND: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24months of follow-up.METHODS: Patients with paroxysmal AF (N=260) enrolled in the MANTRA PAF trial were treated with AAD (N=132) or CA (N=128). At baseline and 3, 6, 12, 18 and 24months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test.RESULTS: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p=0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24months of follow-up.CONCLUSION: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.",

keywords = "Adult, Aged, Anti-Arrhythmia Agents/therapeutic use, Atrial Fibrillation/epidemiology, Atrial Premature Complexes/epidemiology, Catheter Ablation/methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Treatment Outcome",

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 = "2017",

month = oct,

day = "1",

doi = "10.1016/j.ijcard.2017.05.028",

language = "English",

volume = "244",

pages = "186--191",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation

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 - 2017/10/1

Y1 - 2017/10/1

N2 - BACKGROUND: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24months of follow-up.METHODS: Patients with paroxysmal AF (N=260) enrolled in the MANTRA PAF trial were treated with AAD (N=132) or CA (N=128). At baseline and 3, 6, 12, 18 and 24months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test.RESULTS: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p=0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24months of follow-up.CONCLUSION: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.

AB - BACKGROUND: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24months of follow-up.METHODS: Patients with paroxysmal AF (N=260) enrolled in the MANTRA PAF trial were treated with AAD (N=132) or CA (N=128). At baseline and 3, 6, 12, 18 and 24months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test.RESULTS: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p=0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24months of follow-up.CONCLUSION: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA.

KW - Adult

KW - Aged

KW - Anti-Arrhythmia Agents/therapeutic use

KW - Atrial Fibrillation/epidemiology

KW - Atrial Premature Complexes/epidemiology

KW - Catheter Ablation/methods

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Treatment Outcome

U2 - 10.1016/j.ijcard.2017.05.028

DO - 10.1016/j.ijcard.2017.05.028

M3 - Journal article

C2 - 28506548

SN - 0167-5273

VL - 244

SP - 186

EP - 191

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation

Abstract

Keywords

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