Non-pulmonary vein mediated atrial fibrillation: A novel sub-phenotype

Maureen Farrell, Zachary Yoneda, Jay Montgomery, Diane Crawford, Lauren Lee Wray, Meng Xu, Matthew J Kolek, Travis Richardson, Ricardo Lugo, Mohamed Metawee, Greg Michaud, Juan Carlos Estrada, Pablo Saavedra, Sharon Shen, Arvindh Kanagasundram, Christopher R Ellis, George Crossley, Dan Roden and M Benjamin Shoemaker

PLOS ONE, 2017, vol. 12, issue 9, 1-13

Abstract: Background: Atrial fibrillation (AF) is a mechanistically heterogeneous disorder, and the ability to identify sub-phenotypes (“endophenotypes”) of AF would assist in the delivery of personalized medicine. We used the clinical response to pulmonary vein isolation (PVI) to identify a sub-group of patients with non-PV mediated AF and sought to define the clinical associations. Methods: Subjects enrolled in the Vanderbilt AF Ablation Registry who underwent a repeat AF ablation due to arrhythmia recurrence were analyzed on the basis of PV reconnection. Subjects who had no PV reconnection were defined as “non-PV mediated AF”. A comparison group of subjects were identified who had AF that was treated with PVI-only and experienced no arrhythmia recurrence >12 months. They were considered a group enriched for “PV-mediated AF”. Univariate and multivariable binary logistic regression analysis was performed to investigate clinical associations between the PV and non-PV mediated AF groups. Results: Two hundred and twenty nine subjects underwent repeat AF ablation and thirty three (14%) had no PV reconnection. They were compared with 91 subjects identified as having PV-mediated AF. Subjects with non-PV mediated AF were older (64 years [IQR 60,71] vs. 60 [52,67], P = 0.01), more likely to have non-paroxysmal AF (82% [N = 27] vs. 35% [N = 32], P

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0184354

DOI: 10.1371/journal.pone.0184354

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