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

Research output: Contribution to journalArticle

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.

Details

Authors
  • 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
External organisations
  • Hvidovre Hospital
  • Helsinki University Central Hospital
  • Linköping University Hospital
  • Örebro University Hospital
  • Kuopio University Hospital
  • Aarhus University Hospital
  • Skåne University Hospital
  • Copenhagen University Hospital
  • University Hospital Leipzig
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Age, Arrhythmia, Premature ectopic beats, Recurrence, Treatment
Original languageEnglish
Pages (from-to)122-127
JournalInternational Journal of Cardiology
Volume250
Early online date2017
Publication statusPublished - 2018
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes