Produção Nacional
Revisado por pares
Avaliação da recidiva da fibrilação atrial após ablação da veia pulmonar por radiofreqüência baseada em sintomas: esta é uma estratégia confiável?
2006; Sociedade Brasileira de Cardiologia (SBC); Volume: 86; Issue: 5 Linguagem: Inglês
10.1590/s0066-782x2006000500014
ISSN1678-4170
AutoresPaulo Roberto Benchimol‐Barbosa, Paulo Roberto Benchimol‐Barbosa,
Tópico(s)Cardiac pacing and defibrillation studies
ResumoThe impact of symptom-guided perception of atrial fi brillation (AF) recurrence after pulmonary vein radiofrequency ablation (PVRFA) has raised serious concern as a potential flaw in taking into account successful procedures. Although the defi nition of success may vary, bidirectional block through ablated regions is unnecessary in order to achieve a successful procedure¹, and in previously symptomatic patients short and long-term success of PVRFA is focused on detection of symptomatic episodes². Thus, asymptomatic AF episodes are not necessarily credited as recurrence. It is noteworthy that, as a potentially curative procedure, successful PVRFA implies long-term maintenance of sinus rhythm and further reduction of AF-related morbidities, e.g. cardio-embolism. Therefore, anticoagulant withdrawal is the aim.Using seven-day continuous ambulatory ECG monitoring, Hindricks et al³ demonstrated that asymptomatic recurrence of AF increased from 5% to roughly 36% during a 12-month follow-up. Same authors³ reported that when symptom-guided, a 70% rate of freedom of AF episodes after PVRFA in a six-month follow-up was observed. Rate of freedom decreased from 70% to 50% when assessed by seven-day continuous ambulatory ECG monitoring, and further to 45% when transtelephonic ECG transmission was employed. In this scenario, the actual rate of recurrence of AF episodes after PVRFA is proposed as being higher than previously reported using similar techniques
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