Impact of catheter ablation in patients with atrial flutter and concurrent heart failure
| Autor: | Jayakumar Sahadevan, Chinmay Jani, Zachary Zuzek, Sopan Lahewala, Rahul Jaswaney, Shilpkumar Arora, Richard Josephson, Brian D. Hoit, Abhishek Deshmukh, Juan F. Viles-Gonzalez, Nirav Arora, Harsh Patel, Judith A. Mackall, Samarthkumar Thakkar, Mohammed Najeeb Osman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry medicine.medical_treatment Hazard ratio Catheter ablation Atrial fibrillation Retrospective cohort study Heart failure Atrial flutter Ablation medicine.disease Nationwide Readmissions Database Clinical RC666-701 Internal medicine Cardiology Diseases of the circulatory (Cardiovascular) system Medicine Erratum Heart failure with preserved ejection fraction business |
| Zdroj: | Heart Rhythm O2 Heart Rhythm O2, Vol 2, Iss 1, Pp 53-63 (2021) |
| ISSN: | 2666-5018 |
| Popis: | Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF). Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF. Methods: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016–17 Nationwide Readmissions Database. The primary outcome was a composite of all-cause mortality and/or HF readmission at 1 year. Secondary outcomes included HF readmission, all-cause mortality, and atrial fibrillation (AF) readmission at 1 year. Propensity score match (1:2) algorithm was used to adjust for confounders. Cox proportional hazard regression was used to generate hazard ratios. Results: Of the 15,952 patients, 9889 had heart failure with reduced ejection fraction (HFrEF) and 6063 had heart failure with preserved ejection fraction (HFpEF). In the matched HFrEF cohort (n = 5421), the primary outcome was significantly lower in patients undergoing ablation (HR 0.72, 95% CI 0.61–0.85, P < .001). HF readmission (HR 0.73, 95% CI 0.61–0.89, P = .001), all-cause mortality (HR 0.62, 95% CI 0.46–0.85, P = .003), and AF readmission (HR 0.63, 95% CI 0.48–0.82, P = .001) were also significantly reduced. In the matched HFpEF cohort (n = 2439), the primary outcome was lower in the group receiving ablation but was not statistically significant (HR 0.80, 95% CI 0.63–1.01, P = .065). Conclusion: In patients with AFL and HFrEF, AFL ablation was associated with lower mortality and HF readmissions at 1 year. Patients with AFL and HFpEF did not show a similar significant reduction in the primary outcome. |
| Databáze: | OpenAIRE |
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