Population-level evaluation of complications after catheter ablation in patients with atrial fibrillation and heart failure.
J Cardiovasc Electrophysiol
; 30(12): 2678-2685, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31578788
ABSTRACT
INTRODUCTION:
Catheter ablation (CA) has been increasingly used to treat atrial fibrillation (AF) in patients with heart failure (HF), however, its safety at the population-level has not yet been evaluated. To assess the safety of CA in AF-HF patients, the frequency and potential risk factors for adverse events (AEs) within 30 days post-CA were determined.METHODS:
A population-based cohort of AF-HF patients who underwent CA in Quebec, Canada (2000-2017) was constructed using administrative databases. Major AEs included all-cause mortality, cerebrovascular accident (CVA), pericardial effusion requiring drainage (PERD), vascular AEs, hemorrhage/hematoma, and pulmonary embolism. Univariate logistic regression models were employed to assess potential risk factors for major AEs.RESULTS:
Of 700 AF-HF patients who underwent CA (median age 64.5 years [interquartile range, IQR, 56.2-71.0], 22.0% female, and median CHA2 DS2 -Vasc 3 [IQR, 2-4]), 14 (2.0%) patients developed 16 major AEs within 30 days of CA. Hemorrhage/hematoma was the most frequent major AE (four patients; 0.6%) followed by all-cause mortality, CVA/TIA, PERD, and vascular AEs (three patients each; 0.4%). Coronary artery disease (odds ratio [OR], 3.9 [95% confidence interval, CI, 1.2-12.3]) and age ≥65 years (OR, 3.1 [95% CI, 1.1-9.8]) were identified predictors for the composite outcome of major AEs. More than half of the patients (57.2%) underwent a second CA within a median of 0.8 (IQR, 0.2-2.2) years from the date of first CA.CONCLUSION:
CA performed in the AF-HF population portends a relatively low incidence of major AEs. A larger study is required to determine whether certain patient factors are independently associated with a higher risk of post-CA AEs.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Fibrilación Atrial
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Ablación por Catéter
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Insuficiencia Cardíaca
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2019
Tipo del documento:
Article