Catheter Ablation for Atrial Fibrillation in Patients With Concurrent Heart Failure
| Autor: | Richard Josephson, Nirav Arora, Mohini Patel, Rahul Jaswaney, Byomesh Tripathi, Harsh Patel, Siva K. Mulpuru, Samarthkumar Thakkar, Shilpkumar Arora, Chinmay Jani, Zachary Zuzek, Guru Kowlgi, Brian D. Hoit, Juan F. Viles-Gonzalez, Christopher V. DeSimone, Mohammed Najeeb Osman, Abhishek Deshmukh, Sopan Lahewala, Nilay Patel |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Catheter ablation Comorbidity 030204 cardiovascular system & hematology 03 medical and health sciences Young Adult 0302 clinical medicine Recurrence Risk Factors Internal medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Aged Retrospective Studies Heart Failure Ejection fraction business.industry Atrial fibrillation Retrospective cohort study Stroke Volume Middle Aged medicine.disease Confidence interval United States Survival Rate Heart failure Propensity score matching Cohort Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American journal of cardiology. 137 |
| ISSN: | 1879-1913 |
| Popis: | Due to limited real-world data, the aim of this study was to explore the impact of catheter ablation (CA) for atrial fibrillation (AF) in heart failure (HF). This retrospective cohort study identified 119,694 patients with AF and HF from the Nationwide Readmissions Database (NRD) from 2016 to 2017. Propensity-matching was generated using demographics, comorbidities, hospital and other characteristics through multivariate logistic regression. Greedy's propensity score match (1:15) algorithm was used to create matched data. The primary end point was a composite of HF readmission and mortality at 1 year. Secondary outcomes include HF readmission, mortality, AF readmission, and any-cause readmission at 1 year. Of the 119,694 patients, 63,299 had HF with reduced ejection fraction (HFrEF), and 56,395 had HF with preserved ejection fraction (HFpEF). In the overall HFrEF cohort, the primary outcome was similar (HR, 95% confidence interval, p-value) (1.01, 0.91 to 1.13, 0.811). AF readmission (0.41, 0.33 to 0.49,0.001) and any readmission (0.87, 0.82 to 0.93,0.001) were reduced with CA. In the propensity-matched HFrEF cohort, results were unchanged (primary outcome: 1.10, 0.95 to 1.27, 0.189; AF readmission: 0.46, 0.36 to 0.59,0.001; any readmission: 0.89, 0.82 to 0.98, 0.015). In the overall HFpEF cohort, the primary outcome was similar (0.90, 0.78 to 1.04, 0.154). AF readmission was reduced with CA (0.54, 0.44 to 0.65,0.001). In the propensity-matched HFpEF cohort, results were unchanged (primary outcome 1.10, 0.92 to 1.31, 0.289; AF readmission 0.44, 0.33 to 0.57,0.001). CA did not reduce mortality and HF readmission at one year irrespective of the type of HF, but significantly reduce readmission due to AF. |
| Databáze: | OpenAIRE |
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