Risk factors of atrial fibrillation recurrence despite successful radiofrequency ablation of accessory pathway: At 11 years of follow-up

Orczykowski, Michał; Urbanek, Piotr; Bodalski, Robert; Derejko, Paweł; Warmiński, Grzegorz; Łodyga, Małgorzata; Łasocha, Damian; Mazurkiewicz, Łukasz; Dąbrowski, M; Tyczyński, Paweł; Zakrzewska-Koperska, Joanna; Baranowski, Rafał; Oręziak, Artur; Sterliński, Maciej; Bilińska, Maria; Szumowski, Łukasz

doi:10.5603/cj.a2017.0055

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…In addition, age is deemed to be an independent predictor of stroke in patients with AF [9]. Age of≥70 years is frequently accompanied by multiple comorbidities, and is a significant risk factor associated with worse postoperative results [10][11][12][13]. Thus, whether concomitant BRFA should be performed in elderly patients is controversial.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

Lin

Luo

et al. 2020

J Cardiothorac Surg

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Abstracts Background Concomitant bipolar radiofrequency ablation and valve replacement in the elderly remains controversial. In the current study, we aimed to compare the outcomes of concomitant valve replacement and bipolar radiofrequency ablation with valve replacement alone in elderly patients with atrial fibrillation (AF). Methods This was a retrospective study of patients aged ≥70 years who underwent valve replacement with or without bipolar radiofrequency ablation in a single-centre between January 2006 and March 2015. The early postoperative results and long-term clinical outcomes were compared after propensity score matching. Results A total of 34 pairs of patients (73.94 ± 2.64 years old; 34 in the AF with ablation group and 34 in the AF without ablation group) were enrolled in the propensity score matching analysis. There were no significant differences between the two matched groups in terms of surgical mortality (5.88% vs. 2.94%, P = 0.555) and major postoperative morbidity. Kaplan–Meier analysis revealed a significantly better overall survival in the AF with ablation group compared to the AF without ablation group (P = 0.009). Cumulative incidence curves showed a lower incidence of cardiovascular death in the AF with ablation group (P = 0.025, Gray’s test). Patients in the AF with ablation group had a reduced incidence of stroke compared to patients in the AF with ablation group (P = 0.009, Gray’s test). The freedom from AF after 5 years was 58.0% in the AF with ablation group and 3.0% in the AF without ablation group. Conclusions The addition of bipolar radiofrequency ablation is a safe and feasible procedure, even in patients aged ≥70 years, with a better long-term survival and a reduced incidence of stroke compared to valve replacement alone. These findings suggest that bipolar radiofrequency ablation should always be considered as a concomitant procedure for elderly patients with AF who require cardiac surgery. However, a large-scale, prospective, multi-centre, randomized study should be performed in the future to fully validate our findings.

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Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

Lin

Luo

et al. 2020

J Cardiothorac Surg

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“…Meanwhile age is deemed to be an independent predictor of stroke in patients with AF [9]. Age of≥70 years is frequently accompanied by multiple co-morbidities, and is a signi cant risk factor associated with worse postoperative results [10] [11] [12] [13]. Thus, whether concomitant BRFA should be performed in elderly patients is controversial.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, Safety, and Long-term Survival of Concomitant Valve Replacement and Bipolar Radiofrequency Ablation in Patients Aged 70 Years and Older: A Comparative Study With Propensity Score Matching From a Single-Center

Lin

Luo

et al. 2020

Preprint

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Background: Concomitant bipolar radiofrequency ablation and valve replacement in the elderly remains controversial. We aim to compare the outcomes of concomitant valve replacement and bipolar radiofrequency ablation with valve replacement alone in elderly patients with atrial fibrillation (AF).Methods: This was a retrospective study of patients aged ≥ 70 years who underwent valve replacement with or without bipolar radiofrequency ablation in a single-center between January 2006 and March 2015. Early postoperative results and long-term clinical outcomes were compared after propensity score matching.Results: 34 pairs of patients (73.94±2,64 years old, 34 in the AF ablated group and 34 in the AF untreated group) were enrolled in the propensity score matching analysis. No significant differences between the two matched groups were found about surgical mortality (5.88% vs. 2.94%, P=0.555) and major postoperative morbidity. Kaplan–Meier analysis revealed a significantly better overall survival (P=0.009) in the AF ablated group. Cumulative incidence curves showed a lower incidence of cardiovascular death in the AF ablated group (P=0.025, Gray’s test). Patients in the AF ablated group had a reduced incidence of stroke events compared with patients in the AF untreated group (P=0.009, Gray’s test). Freedom from AF after 5 years was 58.0% in the AF ablated group, compared with 3.0% in the AF untreated group.Conclusions: The addition of bipolar radiofrequency ablation is a feasible and safe procedure even in patients aged ≥ 70 years, with a better long-term survival and a reduced incidence of stroke events compared with valve replacement alone. These findings suggest that bipolar radiofrequency ablation should always be considered as a concomitant procedure for elderly patients with AF presenting for cardiac surgery.

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“…Дополнительные предсердно-желудочковые соединения (ДПЖС) встречаются у 0,1-0,3% общей популяции. У больных с ДПЖС частота возникновения фибрилляции предсердий (ФП) составляет 30%, что намного больше, чем в общей популяции (3-4%) [1]. ДПЖС играют патофизиологическую роль в развитии ФП у данной категории пациентов.…”

Section: Introductionunclassified

“…Возникновение ФП у больных с ДПЖС может сопровождаться обмороками, коллапсами, клинической картиной остановки кровообращения и привести к внезапной сердечной смерти (ВСС) [3]. Если дополнительный путь имеет короткий антеградный эффективный рефрактерный период, происходит увеличение частоты сокращений желудочков, что может вызвать фибрилляцию желудочков [1,2,4], при этом частота желудочковых сокращений может достигать более 300 уд/мин [2,5]. Вероятность развития ВСС у бессимптомных больных низка, однако она очень высока у симптомных пациентов [6].…”

Section: Introductionunclassified

“…Вероятность развития ВСС у бессимптомных больных низка, однако она очень высока у симптомных пациентов [6]. К группе высокого риска относятся больные, у которых во время приступа тахикардии наблюдается укорочение интервала R-R менее 250 мс [1,2,6,7]. Отмечено, что с возрастом происходит замедление проведения по дополнительному пути, а в некоторых случаях даже полное его исчезновение [6].…”

Section: Introductionunclassified

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Electrophysiological diagnostics and radiofrequency ablation in a patient with multiple additional atrioventricular connections

Danilova¹,

Lyubkina²,

Serguladze³

et al. 2018

Ann aritm

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Представленный случай демонстрирует успешное устранение с помощью катетерной аблации трех видов тахиаритмий с различными типами сочетаний проведений по дополнительным путям, а также фибрилляции предсердий при множественных дополнительных предсердно-желудочковых соединениях, в результате чего потребовалось применение двухэтапного подхода. В рентгенооперационной при картировании на тахикардии отмечались две морфологии антидромной тахикардии с длительностью цикла 280 и 250 мс и ортодромная реципрокная тахикардия с чередованием короткого и длинного циклов 320-380 мс, а также фибрилляция предсердий с проведением по дополнительному пучку. В настоящее время радиочастотная аблация позволяет эффективно устранять такие сложные случаи, как наличие множественных дополнительных предсердно-желудочковых соединений, при которых встречаются несколько видов тахиаритмий. Ключевые слова: синдром Вольфа-Паркинсона-Уайта; множественные дополнительные предсердно-желудочковые соединения; фибрилляция предсердий с проведением по дополнительным предсердно-желудочковым соединениям; радиочастотная катетерная аблация.

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Risk factors of atrial fibrillation recurrence despite successful radiofrequency ablation of accessory pathway: At 11 years of follow-up

Abstract: Older patient age, longer history of AF and AT prior to RFCA of APs identified a sub-group of patients who required additional treatment. In the multivariate analysis, the history of AF in years (p = 0.043) was a risk factor for AF recurrence.

Cited by 7 publications

References 24 publications

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

Efficacy, Safety, and Long-term Survival of Concomitant Valve Replacement and Bipolar Radiofrequency Ablation in Patients Aged 70 Years and Older: A Comparative Study With Propensity Score Matching From a Single-Center

Electrophysiological diagnostics and radiofrequency ablation in a patient with multiple additional atrioventricular connections

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