Pulmonary vein isolation in a real-world population does not influence QTc interval

Aims We aimed to examine whether routine pulmonary vein isolation (PVI) induces significant ventricular repolarization changes as suggested earlier.

Methods and Results Five-minute electrocardiograms were recorded at hospital's admission (T-1d), 1 day after the PVI-procedure (T+1d) and at 3 months post-procedure (T+3m) from a registry of consecutive atrial fibrillation (AF) patients scheduled for routine PVI with different PVI modalities (radiofrequency, cryo-ablation, and hybrid). Only patients who were in sinus rhythm at all three recordings (n=117) were included. QT-intervals and QT-dispersion were evaluated with custom-made software and QTc was calculated using Bazett's, Fridericia's, Framingham's, and Hodges' formulas. Both QT- and RR-intervals were significantly shorter at T+1d (399 +/- 37 and 870 +/- 141 ms) and T+3m (407 +/- 36 and 950 +/- 140ms) compared with baseline (417 +/- 36 and 1025 +/- 164 ms). There was no statistically significant within-subject difference in QTc Fridericia (T-(1d) 416 +/- 28 ms, T+1d 419 +/- 33 ms, and T(+3m)414 +/- 25 ms) and QT-dispersion (T-(1d)18 +/- 12ms, T+1d 21 +/- 19 ms, and T+3m 17 +/- 12 ms) between the recordings. A multiple linear regression model with age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence to predict the change in QTc at T+3m with respect to QTc at T-1d did not reach significance which indicates that the change in QTc does not differ between all subgroups (age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence).

Conclusion Based on our data a routine PVI does not result in a prolongation of QTc in a real-world population. These findings, therefore, suggest that there is no need to intensify post-PVI QT-interval monitoring.