Impact of Chronic Obstructive Pulmonary Disease on Atrial Fibrillation Ablation Outcomes According to the National Readmission Database

Maraey, Ahmed; Maqsood, Muhammad Haisum; Khalil, Mahmoud; Hashim, Azian; Elzanaty, Ahmed; Elsharnoby, Hadeer; Elsheikh, Eman; Elbatanony, Lamiaa; Ong, Kenneth; Chacko, Paul

doi:10.19102/icrm.2022.130806

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…Some reports have previously associated COPD with a higher risk of AF recurrence after ablation 13 , 35 , 36 and lower rates of successful electrical cardioversion, 37 although sometimes with conflicting results. 38 , 39 Concerns on the efficacy of such procedures in patients with COPD may therefore explain the lower use that we observed in these subjects. Similarly, several hypotheses can explain the lower odds of receiving some drugs that we observed in patients with COPD.…”

Section: Discussionmentioning

confidence: 87%

Impact of chronic obstructive pulmonary disease in patients with atrial fibrillation: an analysis from the GLORIA-AF registry

Romiti,

Corica,

Mei

et al. 2023

Europace

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Aims Chronic Obstructive Pulmonary Disease (COPD) may influence management and prognosis of Atrial Fibrillation (AF), but this relationship has been scarcely explored in contemporary global cohorts. We aimed to investigate the association between AF and COPD, in relation to treatment patterns and major outcomes. Methods From the prospective, global GLORIA-AF Registry, we analysed factors associated with COPD diagnosis, as well as treatment patterns and risk of major outcomes in relation to COPD. Primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACEs). Results 36,263 patients (mean age 70.1±10.5 years, 45.2% females) were included; 2,261 (6.2%) had COPD. Prevalence of COPD was lower in Asia, and higher in North America. Age, female sex, smoking, BMI, and cardiovascular comorbidities were associated with presence of COPD. COPD was associated with higher use of OAC (adjusted Odds Ratio [aOR] and 95% Confidence Interval [CI]: 1.29 [1.13-1.47]), and higher OAC discontinuation (adjusted Hazard Ratio [aHR] and 95%CI: 1.12 [1.01-1.25]). COPD was associated with less use of beta-blocker (aOR [95%CI]: 0.79 [0.72-0.87]), amiodarone and propafenone, and higher use of digoxin and verapamil/diltiazem. Patients with COPD had higher hazard of primary composite outcome (aHR [95%CI]: 1.78 [1.58-2.00]); no interaction was observed regarding beta-blocker use. COPD was also associated with all-cause death (aHR [95%CI]: 2.01 [1.77-2.28]), MACEs (aHR [95%CI]: 1.41 [1.18-1.68]) and major bleeding (aHR [95%CI]: 1.48 [1.16-1.88]). Conclusions In AF patients, COPD was associated with differences in OAC treatment and use of drugs. AF/COPD patients had worse outcomes, including higher mortality, MACE and major bleeding.

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Section: Discussionmentioning

confidence: 87%

Impact of chronic obstructive pulmonary disease in patients with atrial fibrillation: an analysis from the GLORIA-AF registry

Romiti,

Corica,

Mei

et al. 2023

Europace

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“…It is the risk factor for developing thromboembolism, against which secondary pulmonary hypertension may occur [46]. In addition, pulmonary hypertension may worsen the condition in patients with AF and COPD by increasing right atrial overload or stretch in COPD patients [47]. Accordingly, overload and dilatation of the left atrium (LA) are observed, and the time of conduction of electrical impulses through the atria increases, which may be the cause of AF.…”

Section: Pulmonary Hypertensionmentioning

confidence: 99%

Features of Atrial Fibrillation Pathogenesis and Prognosis in Chronic Obstructive Pulmonary Patients during the COVID-19 Pandemic

Hazarapetyan¹,

Zelveian²,

Grigoryan³

2023

Rev. Cardiovasc. Med.

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Background: Atrial fibrillation (AF) is observed in arterial hypertension, heart failure, ischemic heart disease, and pulmonary pathology, particularly, chronic obstructive pulmonary disease (COPD). COPD in turn is a risk factor for developing these cardiovascular diseases and various arrhythmias. In the coronavirus disease (COVID) situation, such comorbid patients are the most vulnerable group with a high risk of adverse outcomes. The relevance of the relationship between COPD and coronavirus infection is explained by the similarity of clinical and pathophysiological manifestations, creating more difficulties in diagnosing and determining rational treatment. The aim of the current study is to explore the role COPD plays in the onset and progression of AF, especially in the situation of COVID-19. Methods: We searched PubMed databases and included studies with information on comorbid patients suffering from COPD and AF, as well as similar patients in the context of COVID-19. Results: A modern view on the problem of comorbidity of COPD and AF is presented. In the presence of cardiorespiratory comorbidity, symptoms of mutual worsening of the clinical course are observed, due to the commonality of some links of pathogenesis, including hypoxia, hemodynamic disturbances, activation of the sympathoadrenal system, systemic inflammation, and development of fibrosis, leading to myocardial remodeling, a decrease in the effectiveness of the therapy, and a worsening prognosis, especially in the context of COVID-19. Conclusions: The results of a study of the features of the pathogenesis and course of AF in COPD are presented, as well as the formation and progression of this comorbid pathology in the context of the COVID-19 pandemic.

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Impact of Chronic Obstructive Pulmonary Disease on Atrial Fibrillation Ablation Outcomes According to the National Readmission Database

Cited by 2 publications

References 33 publications

Impact of chronic obstructive pulmonary disease in patients with atrial fibrillation: an analysis from the GLORIA-AF registry

Impact of chronic obstructive pulmonary disease in patients with atrial fibrillation: an analysis from the GLORIA-AF registry

Features of Atrial Fibrillation Pathogenesis and Prognosis in Chronic Obstructive Pulmonary Patients during the COVID-19 Pandemic

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