Followup
DHF was defined as heart failure requiring medical therapy during
post-procedure hospitalization, or that required re-hospitalization
< 90 days after the procedure. DHF was classified into early
peri-procedural DHF and late peri-procedural DHF; namely, early
peri-procedural DHF was defined as occurring within 2 days after the
procedure and late peri-procedural DHF as occurring ≥ 3 days after the
procedure.
Long-term rhythm outcomes after catheter ablation were followed for 2
years. late phase DHF requiring re-hospitalization in this 2-year period
was also assessed.
A 12-lead ECG and blood tests were performed one day before the
procedure. In accordance with Japanese guidelines, we set cutoff values
for brain natriuretic peptide (BNP) and N-terminal pro-BNP of 100 ng/L
and 400 ng/L, respectively.4 After the procedure, a
12-lead ECG was performed one day after the procedure, and Δheart rate,
which was defined as heart rate after ablation minus heart rate before
ablation, were calculated. ECG monitoring, peripheral oxyhemoglobin
saturation monitoring, and observations by nurses were performed for at
least 2 days after the procedure. In general, ECGs and chest X-rays were
also performed when DHF occurred. If heart rate could not be measured,
pulse rate was measured and substituted for heart rate.
Followup after discharge was performed as a part of routine visits,
usually conducted at 1, 3, 6, 9, 12, 18, and 24 months after the
procedure. Each routine visit included a 12-lead ECG. In addition,
24-hour Holter electrocardiography was performed 6 months after the
procedure.
Early recurrence of AF was defined as atrial tachyarrhythmias detected
by 12-lead ECG or atrial tachyarrhythmias lasting > 30
seconds detected by ECG monitoring or 24-hour Holter monitoring at
< 90 days after the procedure. If early recurrence of AF
occurred, antiarrhythmic drugs were generally used. Electrical
cardioversion was performed according to the chief doctor’s judgment.
AF recurrence was defined as atrial tachyarrhythmias detected by 12-lead
ECG or atrial tachyarrhythmias lasting > 30 seconds
detected by 24-hour Holter electrocardiography ≥ 90 days after the
procedure.