Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation

Pappone, Carlo; Rosanio, Salvatore; Augello, Giuseppe; Gallus, Giuseppe; Vicedomini, Gabriele; Mazzone, Patrizio; Gulletta, Simone; Gugliotta, Filippo; Pappone, Alessia; Santinelli, Vincenzo; Tortoriello, Valter; Sala, Simone; Zangrillo, Alberto; Crescenzi, Giuseppe; Benussi, Stefano; Alfieri, Ottavio

doi:10.1016/s0735-1097(03)00577-1

Cited by 707 publications

(394 citation statements)

References 19 publications

Supporting

Mentioning

359

Contrasting

Unclassified

Order By: Relevance

“…High heart failure rate in readmitted subjects in our study compared with Noseworthy et al13 is partly explained by the greater proportion of subjects aged ≥65 years in our study. Readmission rate because of stroke/TIA and bleeding noted in our study is similar to previously published studies 17, 20, 21, 22…”

Section: Discussionsupporting

confidence: 92%

Causes and Predictors of Readmission in Patients With Atrial Fibrillation Undergoing Catheter Ablation: A National Population‐Based Cohort Study

Arora

Lahewala

Tripathi

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundReducing readmission after catheter ablation (CA) in atrial fibrillation (AF) is important.Methods and ResultsWe utilized National Readmission Data (NRD) 2010–2014. AF was identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD‐9‐CM) diagnostic code 427.31 in the primary field, while first CA of AF was identified via ICD‐9‐procedure code 37.34. Any admission within 30 or 90 days of index admission was considered a readmission. Cox proportional hazard regression was used to adjust for confounders. The primary outcomes were 30‐ and 90‐day readmissions and the secondary outcome was AF recurrence. In total, 1 128 372 patients with AF were identified from January 1, 2010 to September 30, 2014. Of which 37 360 (3.3%) underwent CA. Patients aged ≥65 years and female sex were less likely to receive CA for AF. Overall, 10.9% and 16.5% of CA patients were readmitted within 30 and 90 days post‐CA, respectively. Most common causes of readmissions were arrhythmia (AF, atrial flutter), heart failure, pulmonary causes (pneumonia, chronic obstructive pulmonary disease) and bleeding complications (gastrointestinal bleed, intracranial hemorrhage). Patients with diabetes mellitus, heart failure, coronary artery disease (CAD), chronic pulmonary and kidney disease, prior stroke/transient ischemic attack (TIA), female sex, length of stay ≥2 and disposition to the facility were prone to higher 30‐ and 90‐day readmissions post‐CA. Predictors of increase in AF recurrence post‐CA were female sex, diabetes mellitus, chronic pulmonary disease, and length of stay ≥2. Trends of 90‐day readmission and AF recurrence were found to improve over the study period.ConclusionsWe identified several demographic and clinical factors associated with the use of CA in AF, and short‐term outcomes of the same, which could potentially help in the patient selection and improve outcomes.

show abstract

Section: Discussionsupporting

confidence: 92%

Causes and Predictors of Readmission in Patients With Atrial Fibrillation Undergoing Catheter Ablation: A National Population‐Based Cohort Study

Arora

Lahewala

Tripathi

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…Multiple studies have demonstrated that AF ablation improves QOL in a patient with symptomatic AF, including those with HF. 231,232 Many patients with AF have HF with reduced ejection fraction (EF). Multiple studies have examined the effect of ablation on EF.…”

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

confidence: 99%

“…231,545 To date however, there are no RCTs verifying the hypothesis that ablation lowers the long-term incidence of stroke or TIA. Please refer to Section 7 for a more detailed discussion of the recommendations made by the writing group for long-term anticoagulation post-AF ablation.…”

Section: Outcomes Of Af Ablation In Populations Not Well Represented mentioning

confidence: 99%

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

Self Cite

1,762

1,468

View full text Add to dashboard Cite

“…It is difficult to compare results across trials because of differences in the ablation techniques employed and the heterogeneity of patient populations enrolled (Table 1). 6,29 Catheter ablation appeared superior to AAD therapy in the multicenter Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation (A4) study. 7 The trial, limited to 4 centers, enrolled 112 patients with recurrent AF after treatment with ≥1 AAD.…”

Section: Catheter Ablation For Atrial Fibrillationmentioning

confidence: 99%

“…Insights derive from 1 relatively large observational study, 6 3 metaanalyses, 31 -33 and several smaller randomized trials. 29,34 -36 The observational study included 1171 consecutive patients treated by either complete PVI or medical therapy for AF.…”

Section: Comparison Of Ablation With Aadmentioning

confidence: 99%

Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

Viles-González

Fuster

Halperin

et al. 2011

Clinical Cardiology

View full text Add to dashboard Cite

Antiarrhythmic drug (AAD) therapy may be beneficial for patients with symptoms attributable to atrial fibrillation despite adequate rate control. The limited long-term efficacy of AAD and the relatively large proportion of patients discontinuing therapy because of side effects led to the development of nonpharmacological therapies to achieve rhythm control. Pressing questions remain about the effect of ablation therapy on long-term patient outcomes. Based on recent clinical trials and meta-analyses, ablation appears more effective and possibly safer than AAD for long-term maintenance of sinus rhythm in selected patients, but the evidence is insufficient to recommend ablation in preference to drug therapy as the first AAD therapy for the majority of patients in whom a rhythm control strategy is justified. Herein, we review the most current evidence supporting the use of AAD and catheter ablation in atrial fibrillation.

show abstract

Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation

Abstract: Pulmonary vein ablation improves mortality, morbidity, and QoL as compared with medical therapy. Our findings pave the way for randomized trials to prospect a wider application of ablation therapy for AF.

Cited by 707 publications

References 19 publications

Causes and Predictors of Readmission in Patients With Atrial Fibrillation Undergoing Catheter Ablation: A National Population‐Based Cohort Study

Causes and Predictors of Readmission in Patients With Atrial Fibrillation Undergoing Catheter Ablation: A National Population‐Based Cohort Study

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

Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

Contact Info

Product

Resources

About