Abstract 14136: Effectiveness of Adaptive Servo-Ventillation for the Prevention of Atrial fibrillation Recurrence after Radiofrequency Catheter Ablation
Bachground: Early recurrence of atrial fibrillation (AF) after successful pulmonary vein electrical isolation (PVI) is indicated as a predictor of late recurrence, the prevention of early recurrence by aggressive intervention improves AF outcome. A novel respiration device called adaptive servo-ventilation (ASV) has been developed for central sleep apnea, ASV therapy improves heart failure and cardiac function. The aim of the present study was to investigate the efficacy of ASV therapy during a short period for preventing AF recurrence after catheter ablation.
Methods: This study consisted of consecutive 112 AF patients (mean age: 64.3±8.1, 87 male, paroxysmal: n=42, persistent: n=37, long-standing: n=33). All patients underwent an overnight full polysomnography and circumferential PVI guided by CARTO system. 56 patients were randomly received ASV therapy (ASV group) with agreement by informed consent at overnight during 3 days after ablation procedure, 4 rejected patients with poor compliance after first introductory night were excluded from this study. Other 56 patient were analyzed as control (non ASV group). Plasma B-type natriuretic peptide (BNP) and serum C reactive protein (CRP) were evaluated before and on 2 days after ablation.
Results: Baseline characteristics did not differ significantly between two groups. Plasma BNP after ablation was significantly lower in ASV group than non ASV group (p<0.01), and Plasma BNP significantly decreased in ASV group (p<0.05). Serum CRP after ablation was increased in non ASV group (p<0.05). Early AF recurrence during 30 days after ablation significantly was lower in ASV group than in non ASV group (ASV goup= 24%, non ASV group=41%, p<0.05). During a follow-up of 14.3 ± 5.7 months, AF free rate in persistent AF patients ( including long-standing persistent AF) was lower in ASV group than in non ASV group (p<0.05 by the log-rank test). Multivariate analysis showed that AF recurrence in persistent AF was associated with was associated with BNP after ablation and E/e’ (p<0.01,p<0.05, respectively).
Conclusion: ASV therapy during a short period after AF ablation improved plasma BNP, and may be effective for AF recurrence, especially in patients with persistent AF.
- © 2012 by American Heart Association, Inc.