Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial

S. Willems, P. Khairy, J.G. Andrade, B.A. Hoffmann, S. Levesque, A. Verma, Rukshen Weerasooriya, P. Novak, T. Arentz, I. Deisenhofer, T. Rostock, D. Steven, L. Rivard, P.G. Guerra, K. Dyrda, B. Mondesert, M. Dubuc, B. Thibault, M. Talajic, D. Roy & 2 others S. Nattel, L. MacLe

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    Abstract

    © 2016 American Heart Association, Inc.Background-Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results-A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia =30 s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6%) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2% in patients without ER compared with 62.6%, 36.4%, and 7.8% in patients with ER 1, 2, and 3 months post ablation, respectively (P90% of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01058980.
    Original languageEnglish
    JournalCirculation: Arrhythmia and Electrophysiology
    Volume9
    Issue number8
    DOIs
    Publication statusPublished - 2016

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    Catheter Ablation
    Pulmonary Veins
    Adenosine
    Atrial Fibrillation
    Recurrence
    Tachycardia
    Clinical Trials
    Guidelines

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    Willems, S. ; Khairy, P. ; Andrade, J.G. ; Hoffmann, B.A. ; Levesque, S. ; Verma, A. ; Weerasooriya, Rukshen ; Novak, P. ; Arentz, T. ; Deisenhofer, I. ; Rostock, T. ; Steven, D. ; Rivard, L. ; Guerra, P.G. ; Dyrda, K. ; Mondesert, B. ; Dubuc, M. ; Thibault, B. ; Talajic, M. ; Roy, D. ; Nattel, S. ; MacLe, L. / Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial. In: Circulation: Arrhythmia and Electrophysiology. 2016 ; Vol. 9, No. 8.
    @article{3c813730b68a4c9295c71697d3dca2ea,
    title = "Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial",
    abstract = "{\circledC} 2016 American Heart Association, Inc.Background-Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results-A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia =30 s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6{\%}) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2{\%} in patients without ER compared with 62.6{\%}, 36.4{\%}, and 7.8{\%} in patients with ER 1, 2, and 3 months post ablation, respectively (P90{\%} of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01058980.",
    author = "S. Willems and P. Khairy and J.G. Andrade and B.A. Hoffmann and S. Levesque and A. Verma and Rukshen Weerasooriya and P. Novak and T. Arentz and I. Deisenhofer and T. Rostock and D. Steven and L. Rivard and P.G. Guerra and K. Dyrda and B. Mondesert and M. Dubuc and B. Thibault and M. Talajic and D. Roy and S. Nattel and L. MacLe",
    year = "2016",
    doi = "10.1161/CIRCEP.115.003909",
    language = "English",
    volume = "9",
    journal = "Circulation: Arrhythmia and Electrophysiology",
    issn = "1941-3084",
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    Willems, S, Khairy, P, Andrade, JG, Hoffmann, BA, Levesque, S, Verma, A, Weerasooriya, R, Novak, P, Arentz, T, Deisenhofer, I, Rostock, T, Steven, D, Rivard, L, Guerra, PG, Dyrda, K, Mondesert, B, Dubuc, M, Thibault, B, Talajic, M, Roy, D, Nattel, S & MacLe, L 2016, 'Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial' Circulation: Arrhythmia and Electrophysiology, vol. 9, no. 8. https://doi.org/10.1161/CIRCEP.115.003909

    Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial. / Willems, S.; Khairy, P.; Andrade, J.G.; Hoffmann, B.A.; Levesque, S.; Verma, A.; Weerasooriya, Rukshen; Novak, P.; Arentz, T.; Deisenhofer, I.; Rostock, T.; Steven, D.; Rivard, L.; Guerra, P.G.; Dyrda, K.; Mondesert, B.; Dubuc, M.; Thibault, B.; Talajic, M.; Roy, D.; Nattel, S.; MacLe, L.

    In: Circulation: Arrhythmia and Electrophysiology, Vol. 9, No. 8, 2016.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Redefining the Blanking Period after Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial

    AU - Willems, S.

    AU - Khairy, P.

    AU - Andrade, J.G.

    AU - Hoffmann, B.A.

    AU - Levesque, S.

    AU - Verma, A.

    AU - Weerasooriya, Rukshen

    AU - Novak, P.

    AU - Arentz, T.

    AU - Deisenhofer, I.

    AU - Rostock, T.

    AU - Steven, D.

    AU - Rivard, L.

    AU - Guerra, P.G.

    AU - Dyrda, K.

    AU - Mondesert, B.

    AU - Dubuc, M.

    AU - Thibault, B.

    AU - Talajic, M.

    AU - Roy, D.

    AU - Nattel, S.

    AU - MacLe, L.

    PY - 2016

    Y1 - 2016

    N2 - © 2016 American Heart Association, Inc.Background-Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results-A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia =30 s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6%) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2% in patients without ER compared with 62.6%, 36.4%, and 7.8% in patients with ER 1, 2, and 3 months post ablation, respectively (P90% of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01058980.

    AB - © 2016 American Heart Association, Inc.Background-Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. Methods and Results-A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Patients with atrial tachyarrhythmia =30 s within the 3-month blanking period were stratified according to the timing of ER. A total of 179 patients (44.6%) experienced their last episode of ER during the first (n=53), second (n=44), or third (n=82) month of the 3-month blanking period. One-year freedom from symptomatic atrial tachyarrhythmia was 77.2% in patients without ER compared with 62.6%, 36.4%, and 7.8% in patients with ER 1, 2, and 3 months post ablation, respectively (P90% of patients with ER during the third month post ablation experience late recurrence by 1 year. However, pending further study, repeat ablation before 90 days cannot be routinely advocated. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01058980.

    U2 - 10.1161/CIRCEP.115.003909

    DO - 10.1161/CIRCEP.115.003909

    M3 - Article

    VL - 9

    JO - Circulation: Arrhythmia and Electrophysiology

    JF - Circulation: Arrhythmia and Electrophysiology

    SN - 1941-3084

    IS - 8

    ER -