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- Stabile, Giuseppe, et al.
(författare)
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Atrial fibrillation history impact on catheter ablation outcome : Findings from the ESC-EHRA atrial fibrillation ablation long-term registry
- 2019
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley. - 0147-8389 .- 1540-8159. ; 42:3, s. 313-320
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atrial fibrillation (AF) promotes atrial remodeling that in turn promote AF perpetuation. The aim of our study was to investigate the impact of AF history length on one-year outcome of AF catheter ablation in a cohort of patients enrolled in the Atrial Fibrillation Ablation Registry.METHODS: We described the real-life clinical epidemiology, therapeutic strategies and the short- and mid-term outcomes of 1948 patients (71.9% with paroxysmal AF) undergoing AF ablation procedures, stratified according to AF history duration (< 2 years or ≥ 2 years).RESULTS: The mean AF history duration was 46,2±57,4 months, 592 patients had an AF history duration < 2 years (mean 10,2±5,9 months), and 1356 patients ≥ 2 years (mean 75,5±63,5 months) (P < 0.001). Patients with AF history duration < 2 years were younger, had a lower incidence of hypertension, coronary artery disease, hypertrophic cardiomyopathy and had a lower CHA2 DS2 -VaSc Score. At one year, the logrank test showed a lower incidence of AF recurrence in patients with AF history duration < 2 years (28.9%) than in patients with AF history duration ≥ 2 years (34.0%) (P = 0.037). AF history duration ≥ 2 years, overall ablation procedure duration, hypertension and chronic kidney disease were all predictors of recurrences after the blanking period.CONCLUSIONS: In this multicenter registry, performing catheter ablation in patients with an AF history ≥ 2 years was associated with higher rates of AF recurrences at one year. Since cumulative time in AF in not necessarily equivalent to AF history, its role remains to be clarified.
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| 2. |
- Trines, Serge A., et al.
(författare)
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Influence of risk factors in the ESC-EHRA EORP atrial fibrillation ablation long-term registry
- 2019
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley. - 0147-8389 .- 1540-8159. ; 42:10, s. 1365-1373
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Tidskriftsartikel (refereegranskat)abstract
- Background: The influence of risk factors on atrial fibrillation (AF) ablation recurrence is increasingly recognized. We present a sub-analysis of the European Society of Cardiology-European Heart Rhythm Association-European Society of Cardiology AF ablation long-term registry on the effect of traditional risk factors for AF on postablation recurrence, reablation, and complications using real-world data.Methods: Risk factors for AF were defined as body mass index >= 27 kg/m(2), hypertension, chronic obstructive pulmonary disease, diabetes, alcohol >= 2 units/day, sleep apnea, smoking, no/occasional sports activity, moderate/severe mitral or aortic valve disease, any cardiomyopathy, peripheral vascular disease, chronic kidney disease, heart failure, coronary artery disease/infarction, and previous pacemaker/defibrillator implant. Patients were divided in two groups with >= 1 or without risk factors. Primary outcomes were arrhythmia recurrence after blanking period, reablation, and adverse events or death. Differences between the groups and the influence of individual risk factors were analyzed using multivariate Cox regression.Results: Three thousand sixty nine patients were included; 217 patients were without risk factors. Risk factor patients were older (58.4 vs 54.1 years), more often female (32% vs 19.8%) and had more often persistent AF (27.2% vs 23.5%). In a multivariate analysis, patients without risk factors had a hazard ratio of 0.70 (95% CI 0.49-0.99) for recurrence compared to risk factor patients. The multivariate hazard ratios for reablation or adverse events/death were not different between the two groups. Hypertension and body mass index were univariate predictors of recurrence.Conclusions: Patients with >= 1 risk factor had a 30% higher risk for arrhythmia recurrence after ablation, but no differences in risk for repeat ablations and adverse events or death.
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