Which patients with atrial fibrillation undergo an ablation procedure today in Europe? A report from the ESC-EHRA-EORP Atrial Fibrillation Ablation Long-Term and Atrial Fibrillation General Pilot Registries
Por:
Tilz RR, Dagres N, Arbelo E, Blomström-Lundqvist C, Crijns HJ, Kirchhof P, Kautzner J, Temporelli PL, Laroche C, Roberts PR, Pehrson S, Lip GYH, Brugada-Terradellas J and Tavazzi L
Publicada:
1 feb 2020
Ahead of Print:
26 nov 2019
Resumen:
Aims Rhythm control management in patients with atrial fibrillation (AF) may be unequal across Europe. The aim of this study was to investigate how selective the patient cohort referred for AF ablation is, as compared to the general AF population in Europe, and to describe the governing mechanisms for such selection.
Methods and results Descriptive comparative statistical analyses of the baseline characteristics were performed between the cohorts of Atrial Fibrillation Ablation Long-Term (ESC EORP AFA-LT) registry, designed to provide a picture of contemporary real-world AF ablation, and the AF population from the AF-General (ESC EORP AF-Gen) pilot registry. Data collection was performed using a web-based system. In the AFA and in the Atrial Fibrillation General (AFG) pilot registries, 3593 and 3049 patients were enrolled, respectively. Patients who underwent AF ablation were younger, more commonly male, and had significantly less comorbidities. Atrial Fibrillation Ablation patients often presented without comorbidities, resulting in a lower risk of stroke (CHA(2)DS(2)-VASc >= 5: 2.9% vs. 24.5%, all P<0.001) and bleeding (HAS-BLED >= 2: 8.5% vs. 40.5%, P<0.001) but with European Heart Rhythm Association (EHRA) scores >1 and more prevalent AF-related symptoms such as palpitations, fatigue, and weakness (all P<0.001) as compared to the general AF patients. Atrial Fibrillation Ablation patients were significantly more often male, had higher left ventricular ejection fraction (59.5% vs. 52.4%) and smaller left atrial size on echocardiogram (P<0.001 each).
Conclusion The comparison of the patient cohorts in the AFA and AFG registries showed that AF ablation in European clinical practice is mostly performed in relatively young, symptomatic and relatively healthy patients.
Filiaciones:
Tilz RR:
Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center, Medical Clinic II, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany
Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
DZHK (German Center for Cardiovascular Research), Partner Site, Hamburg/Kiel/Lübeck, Berlin, Germany
Dagres N:
Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
Arbelo E:
Department of Cardiology, Cardiovascular Institute, Hospital Clinic de Barcelona, Universitat de Barcelona, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Blomström-Lundqvist C:
Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden
Crijns HJ:
Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
Kirchhof P:
Institute of Cardiovascular Sciences, University of Birmingham and SWBH and UHB NHS Trusts, Birmingham, Great Britain
Kautzner J:
Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
Temporelli PL:
Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
Laroche C:
EURObservational Research Programme (EORP), ESC, Sophia-Antipolis, France
Roberts PR:
University Hospital Southampton NHS Trust, Southampton, Great Britain
Pehrson S:
Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark
Lip GYH:
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, Great Britain
Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
Brugada-Terradellas J:
Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Barcelona, Spain
Tavazzi L:
Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy
Bronze
|