Score Associated with the Outcome after Multiple Ablation Procedures in Patients with Atrial Fibrillation

Autor:	Christian W. Hamm, Alexander Berkowitsch, Sergey Zaltsberg, Thomas Neumann, Maciej Wójcik, Heinz F. Pitschner, Malte Kuniss
Rok vydání:	2014
Předmět:	medicine.medical_specialty Framingham Risk Score business.industry medicine.medical_treatment Cardiomyopathy Catheter ablation Atrial fibrillation General Medicine medicine.disease Ablation Surgery Internal medicine Cohort Cardiology Medicine Sinus rhythm Metabolic syndrome Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 37:682-690
ISSN:	0147-8389
DOI:	10.1111/pace.12356
Popis:	Background Catheter ablation (CA) of atrial fibrillation (AF) is now established therapeutic option. Multiple procedures (MPs) are often needed to achieve the satisfactory outcome. The aim of the study was to assess the outcome after MPs in AF patients categorized to risk-score groups. Methods We followed a cohort of consecutive 911 (69% male; median 59 years) patients with AF (58% paroxysmal) who had CAAF performed. ALARMEC (Atrial fibrillation type, Left Atrium size, Renal insufficiency, MEtabolic syndrome, cardiomyopathy) risk score was calculated for each patient. The end point was maintenance of sinus rhythm at the follow-up of 60 months. Results We performed 1,199 CAAF procedures. One, two, and three procedures were performed in 663 (73%), 208 (23%), and 40 (4%) patients, respectively. Outcome after the first procedure (56%) was improved with MPs (76%). MPs > 2 were performed in 1%, 3%, 5%, 6%, and 10% patients with ALARMEC score of 0, 1, 2, 3, and 4, respectively. MPs were successful in 89%, 86%, 81%, 65%, and 43% of patients with ALARMEC score of 0, 1, 2, 3, and 4, respectively. Outcome in 174 (19%) patients on antiarrhythmic drugs (AADs) was 85%, 68%, 75%, 44%, and 39% in ALARMEC score: 0, 1, 2, 3, and 4, respectively. Outcome in 737 (81%) patients without AAD was 90%, 85%, 80%, 77%, and 69% in ALARMEC score of 0, 1, 2, 3, and 4, respectively. Conclusion The moderate success rate after index procedure of CAAF can be further improved with multiple ones and AAD.
Databáze:	OpenAIRE
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