Temporal trends and in-hospital complications of catheter ablation for atrial fibrillation among patients with moderate and advanced chronic kidney diseases: 2005-2018.

Autor: Prasitlumkum N; Department of Cardiology, University of California Riverside, Riverside, California, USA., Chokesuwattanaskul R; Division of Cardiovascular Medicine, Department of Medicine, Cardiac Center, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Kaewput W; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Thongprayoon C; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Tokavanich N; Division of Cardiovascular Medicine, Department of Medicine, Cardiac Center, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Bathini T; Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA., Boonpheng B; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA., Vallabhajosyula S; Department of Medicine, Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Cheungpasitporn W; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Jongnarangsin K; Division of Cardiac Electrophysiology, University of Michigan Health Care, Ann Arbor, Michigan, USA.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2022 Mar; Vol. 33 (3), pp. 401-411. Date of Electronic Publication: 2022 Jan 18.
DOI: 10.1111/jce.15354
Abstrakt: Introduction: Real-world data on atrial fibrillation (AF) ablation among moderate and advanced chronic kidney disease (CKD) patients have so far remained scarce, especially in-hospital AF ablation outcomes.
Methods: We drew data from the US National Inpatient Sample to identify hospitalized patients who underwent AF ablation between 2005 and 2018, and further stratified by CKD classification. We assessed the trend of AF ablation, as well as its complications.
Results: A total of 152 630 patients who were primarily hospitalized for AF and underwent ablation were estimated. Among these, CKD patients were found in a total of 1509 participants, with 978, 206, and 325 under CKD3, CKD4, and CKD5/ESKD, respectively. There was a significant increment in admission rates for AF ablation in the CKD population across all CKD classifications (p < .001). All CKD patients were statistically older, with higher coexisting comorbidities, while hypertension was found substantially lower than non-CKD patients (p ≤ .001). Importantly, CKD, especially CKD3 and CKD5/ESKD, was significantly associated with an increased risk of total complications, and total bleeding, Neurological complications were found statistically lower in CKD patients (p = .029), and no mortality rates were significantly different (p = .287).
Conclusion: Our study observed an increase in admission trends for AF ablation among moderate and advanced CKD patients from 2005 to 2018. CKD was strongly associated with higher procedure-related complications and bleeding, but neurological safety profiles and mortalities rates were nonsignificantly different.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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