Abstract 345: Outcomes Associated with Catheter Ablation of Atrial Fibrillation: Insights From The Veteran’s Health Administration
| Autor: | Jehu S Mathew, Thomas J Glorioso, Lucas N Marzec, Mintu P Turakhia, Paul D Varosy, Sanjay Dixit, Jonathan P Piccini, P. Michael Ho |
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| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 8 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.8.suppl_2.345 |
| Popis: | Introduction: Catheter ablation has emerged as an effective intervention for atrial fibrillation (AF) in specific patient populations. However, less is known about outcomes of AF ablation in community-based cohorts and risk factors for recurrent AF hospitalization following ablation. Methods: Using nationwide administrative data from the Veteran’s Health Administration (VHA), we identified patients with a catheter ablation for AF between 2007-2012 by applying a previously validated algorithm based on outpatient and inpatient diagnosis and procedure codes. We excluded sites with fewer than 30 total procedures in the study period. We evaluated descriptive baseline characteristics, 30-day complications, and 1-year outcomes of stroke, heart failure, recurrent AF, and death. Results: The cohort consisted of 1,202 patients who were predominantly middle-aged (mean age 62.5±8.2), male (97%), and Caucasian (91%). Associated comorbidities included hypertension (76%), diabetes (30%), congestive heart failure (27%), and coronary artery disease (10%). Catheter ablation occurred at a median of 31.4 months following AF diagnosis. Medical management prior to ablation included any history of rate (21%) or rhythm (77%) control or anticoagulation therapy (91%). Following ablation, rhythm control (80%) persisted over a strict rate (18%) control strategy (n=634 patients with two years of follow-up). During the index procedure and at 30 days, vascular complications [32 (2.7%) and 63 (5.2%)] and hematomas [32 (2.7%) and 55 (4.6%)] were the most frequent procedural complications. Other rarer complications were pericardial effusion/tamponade [18 (1.5%) and 34 (2.8%)] and pneumothorax/hemothorax [1(0.08%) and 1(0.08%)]. At one year after ablation (n=885 patients with a full year of follow-up), patients were hospitalized for AF (28.9%), repeat ablation (8.5%), heart failure (4.2%), and stroke (0.5%) with an overall mortality of 2.8%. Compared to the overall cohort, recurrent AF hospitalization at one year was worse for patients less than 75 years of age (29.6%) and for those pursuing a rhythm control strategy (31.2%). Conclusion: Veterans undergoing AF ablation are typically older with more comorbidities than the general AF ablation population. Despite these variations, overall outcomes for AF ablation in the VHA are comparable to outcomes in the general population. |
| Databáze: | OpenAIRE |
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