HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up

Calkins, Hugh; Brugada, Josep; Packer, Douglas L.; Cappato, Riccardo; Chen, Shih Ann; Crijns, Harry J.G.M.; Damiano, Ralph J.; Davies, D. Wyn; Haines, David E.; Haı̈ssaguerre, Michel; Iesaka, Yoshito; Jackman, Warren M.; Jaı̈s, Pierre; Kottkamp, Hans; Kuck, Karl Heinz; Lindsay, Bruce D.; Marchlinski, Francis E.; McCarthy, Patrick M.; Mont, Lluı́s; Morady, Fred; Nademanee, Koonlawee; Natale, Andrea; Pappone, Carlo; Prystowsky, Eric N.; Raviele, Antonio; Ruskin, Jeremy N.; Shemin, Richard J.

doi:10.1016/j.hrthm.2007.04.005

Cited by 1,242 publications

(526 citation statements)

References 339 publications

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“…AF was considered PAF when it terminated spontaneously and persisted for <7 days 9. Detailed information of the patients' drinking habit, including the frequency of alcohol consumption, volume of alcohol consumption, type of alcohol consumed, and duration of their drinking history, was collected during hospitalization from patients and their family members.…”

Section: Methodsmentioning

confidence: 99%

Impact of Alcohol Consumption on the Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Takigawa

Takahashi

Kuwahara

et al. 2016

JAHA

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BackgroundAlthough several studies have reported an association between atrial fibrillation (AF) and alcohol, the impact of alcohol consumption on the outcome after catheter ablation (CA) for AF has not been discussed. We aimed to elucidate the effect of alcohol consumption on the outcome of CA for paroxysmal AF.Methods and ResultsWe examined 1361 consecutive patients with paroxysmal AF (mean age, 61±11 years, 334 women) who underwent CA, including 623 (45.8%) patients who consumed alcohol. The clinical characteristics and outcomes of CA were compared between patients who did and did not consume alcohol. No significant differences were seen in the left atrial size, duration of AF history, and incidence of nonpulmonary vein foci between 2 groups (P=NS). Although the AF recurrence‐free rate after the initial CA was higher in patients who did not consume alcohol (261/623 [41.9%] versus 252/738 [34.1%]; mean follow‐up, 44.4±30.7 months; P=0.003), the outcome after the final CA was similar between 2 groups (patients who consumed alcohol: 111/628 [17.7%] versus patients who did not consume alcohol: 138/738 [18.7%]; mean follow‐up, 53.1±25.8 months; P=0.67). The frequency (hazard ratio 1.07 per 1 day/week increase, CI 1.00–1.15, P=0.04) of alcohol consumption was significantly associated with AF recurrence after CA.ConclusionsThe frequency of alcohol consumption may be associated with AF recurrence after the initial CA for paroxysmal AF, but it may not affect the outcome after the final CA.

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Section: Methodsmentioning

confidence: 99%

Impact of Alcohol Consumption on the Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Takigawa

Takahashi

Kuwahara

et al. 2016

JAHA

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“…The 30-second duration was selected based on previous published consensus statements and is used as the minimal duration to define recurrence of AF after catheter ablation. 1,7 This duration of AF has not been linked to a specific outcome of AF. In addition to the duration requirements listed above, the diagnosis of AF requires an ECG or rhythm strip demonstrating: (1) “absolutely” irregular R-R intervals (in the absence of complete atrioventricular [AV] block); (2) no distinct P waves on the surface ECG; and (3) an atrial cycle length (when visible) that is usually less than 200 ms. 2,7 …”

Section: Section 2: Definitions Mechanisms and Rationale For Af Ablmentioning

confidence: 98%

“…1,979 Although the true efficacy of this approach is unknown, studies have suggested that transient AAD use does not prevent late arrhythmia relapses. 935,980 The 5A study randomized 110 consecutive patients with PAF undergoing ablation to empirical AAD therapy vs no AAD therapy for the first 6 weeks after RF catheter ablation.…”

Section: Early Recurrence After Ablationmentioning

confidence: 99%

“…Prior to the publication of the initial consensus report in 2007, the majority of the published literature on AF ablation consisted of uncontrolled single-and multicenter reports. 1 Further, there had been no standardization in the design of clinical trials of AF ablation, and the 2007 and 2012 consensus documents were developed in part to generate standard terminology, definitions, and recommendations for end points, follow-up procedures, and outcome reporting in an effort to make studies more rigorous and consistent. 1,2 …”

Section: Section 9: Outcomes and Efficacymentioning

confidence: 99%

“…1 The 2007 document was also developed in collaboration with the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC). This Consensus Statement on Catheter and Surgical AF Ablation was rewritten in 2012 to reflect the many advances in AF ablation that had occurred in the interim.…”

Section: Section 1: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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1,468

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Enoxaparin Outcomes in Patients With Moderate Renal Impairment

DeCarolis¹,

Thorson²,

Clairmont³

et al. 2012

Arch Intern Med

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Background: Enoxaparin sodium has predictable pharmacokinetics that allow for simplified dosing without laboratory monitoring. Reliance on renal function for excretion may lead to accumulation of enoxaparin in patients with moderate renal impairment. However, there is no dose adjustment recommended for these patients. We conducted a review to compare bleeding events in patients with moderate renal impairment compared with those with normal renal function.Methods: Patients received enoxaparin sodium, 1 mg/ kg, every 12 hours or 1.5 mg/kg once daily between June 1 and November 30, 2009. Moderate renal impairment was defined as creatinine clearance (CrCl) of 30 to 50 mL/min. Normal renal function was defined as CrCl greater than 80 mL/min. The primary outcome was major bleeding, defined as any bleeding resulting in death, hospital admission, lengthened hospital stay, or an emergency department visit. The secondary outcome was thromboembolism.Results: A total of 164 patients met the inclusion criteria: 105 with normal renal function and 59 with moderate renal impairment. The primary outcome occurred in 6 of 105 patients (5.7%) with normal renal function vs 13 of 59 patients (22.0%) with moderate renal impairment, representing an unadjusted odds ratio of 4.7 (95% CI, 1.7-13.0; P =.002). The odds ratio using multivariable logistic regression adjusting for differences in risk was 3.9 (95% CI, 0.97-15.6; P=.055). There was no recurrent thromboembolism in either group. Conclusions:Our results suggest an increased risk of major bleeding in patients with moderate renal impairment who receive enoxaparin. Because enoxaparin is frequently used and outcomes can be life saving or life threatening, we encourage further study of the appropriate dose in patients with moderate renal impairment.

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HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up

Cited by 1,242 publications

References 339 publications

Impact of Alcohol Consumption on the Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Impact of Alcohol Consumption on the Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Enoxaparin Outcomes in Patients With Moderate Renal Impairment

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