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  • A previous study reported that patients with early

    2019-05-06

    A previous study reported that patients with early AF recurrences were significantly less likely to have long-term freedom from recurrent AF than patients without early recurrences [3]. In the present study, landiolol administration tended to improve the mid-term prognosis compared to placebo. In a previous study, corticosteroid administration shortly after AF ablation effectively prevented AF recurrences immediately after ablation and during a 14-month follow-up period [16]. Electrical remodeling (shortening of atrial refractoriness) proceeds within a few days of AF and contributes to increased AF stability, whereas reverse remodeling after the restoration of sinus rhythm occurs much more slowly [20]. A longer AF-free period after AF ablation might have enabled the atria to inhibit electrical, contractile, and structural remodeling and facilitated reverse remodeling, resulting in a greater AF-free rate during the mid-term follow-up period. It is possible that sympathetic activity control immediately after RF application may be important for long-term AF prevention, but the underlying mechanism remains unclear. This study has several limitations. First, the amount of landiolol administered in this study was lower than that in previous reports. High-dose landiolol administration may have anti-inflammatory activity and may exert more preventative effects compared to low-dose landiolol. Second, the preventive value of oral β-blocker use was not investigated in the present study. Recent reports showed that trp channel the selective β1 receptor antagonist bisoprolol is more effective than carvedilol in decreasing the incidence of AF after coronary artery bypass grafting [21] and severe trp channel failure [22]. β1-Selective oral antagonist administration may also suppress immediate AF recurrence after catheter ablation. Finally, landiolol administration tended to improve the mid-term prognosis compared to placebo in the present study. If this study included many more subjects, the preventative effect of landiolol might have been confirmed during mid-term follow up.
    Conclusion Prophylactic low-dose landiolol (0.5μgkg−1min−1) therapy within 3d of RF catheter ablation is effective and safe for preventing immediate AF recurrence within 3d after AF ablation. This result indicated the relationship between sympathetic nervous activity and immediate AF recurrence after catheter ablation.
    Conflict of interest
    Acknowledgments This research was supported, in part, by a grant-in-aid for Scientific Research (No. 25461039) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.
    Introduction Catheter ablation (CA) is a curative treatment option for patients with atrial fibrillation (AF) [1–3]. Reported rates of recurrence following pulmonary vein isolation (PVI) vary according to AF type, lesion concept, operator experience, technical equipment used, and the quality of follow-up [4–8]. Over the past two decades, the procedure has evolved from the ablation of focal AF triggers inside the pulmonary veins (PVs) to wide-area circumferential PV antrum isolation (PVAI) [4,5]. Data concerning the predictors of AF recurrence are limited. In particular, anatomical predictors as assessed by three-dimensional computed tomography (3D-CT) imaging are not well established [9–12]. In the present study, we sought to determine whether anatomical variables of the left atrium (LA) and PVs assessed by 3D-CT imaging were associated with the recurrence of AF after CA.
    Materials and methods
    Results
    Discussion
    Conclusions
    Conflict of interest
    Acknowledgments
    Introduction The wearable cardioverter defibrillator (WCD; Life Vest 4000, Zoll, PA, USA) is an external defibrillator vest that automatically detects and treats ventricular tachyarrhythmias without bystander assistance [1–3]. Patients with early post-myocardial infarction (MI) are potentially at significant risk of sudden cardiac death (SCD). However, information for prescribing WCD to patients in the early post-MI phase is limited [4]. This study describes a single-center experience of the utility of WCD therapy in these patients in Germany.