Abstract 2516: Inducibility of Atrial Tachyarrhythmias after Extensive Encircling Pulmonary Vein Isolation is Not Related to Subsequent Clinical Outcomes
Background: Several reports showed the non-inducibility of atrial fibrillation (Af) can be an end point for ablative procedures for Af. The inducibility of atrial tachyarrhythmias after the extensive encircling pulmonary vein (PV) isolation (EEPVI) and its implication on the recurrences of Af or atrial tachycardia (AT) after EEPVI have remained investigated.
Methods & Results: Among 148 patients with Af who underwent the EEPVI with (n=42) or without concomitant cavo-tricuspid isthmus ablation (n=106) (age=54±10 years, paroxysmal/persistent=125/ 23), burst atrial pacing (paced cycle length: 180 ±20msec) was performed from right (n=117, 79%) or left atrium (n=31, 21%) to test the inducibility of the atrial tachyarrhythmias just after the successful EEPVI. Among 75 patients (51%), sustained (≥30sec) Af (n=50, 34%) or AT (n=25, 17%) was induced, while among 59 patients (40%) induced Af or AT terminated spontaneously within 5 minutes. In the remaining 14 patients (9%), neither Af nor AT was inducible. During the post-EEPVI follow-up periods without antiarrhythmic drugs, 77 patients (52%, group-R) had recurrences of sustained Af (n=70, 47%) or AT (n=7, 5%) 21+/−53 days after the EEPVI, while in the other 71 patients (48%, group-NR) no recurrence was documented. The inducibility of sustained Af/AT at the end of the EEPVIs did not differ between group-R and group-NR (49% vs 52%, respectively: p>0.05).
Conclusions: Sustained Af/AT was inducible in 51% just after successful EEPVIs and their inducibilities were not related to the subsequent recurrences of Af/AT. The “non-inducibility criteria” appears to be inappropriate as an ablation end point of the EEPVIs.