Impact of proton pump inhibitors on mortality and severe esophageal injury after catheter ablation for atrial fibrillation: a nationwide retrospective study using propensity score matching

2021 ◽  
Author(s):  
Yusuke Ugata ◽  
Nobuaki Michihata ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Hideo Yasunaga
Keyword(s):  
Atrial Fibrillation ◽  
Retrospective Study ◽  
Catheter Ablation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Esophageal Injury

scholarly journals Efficacy and safety of 50-60 Watt high-power short-duration radiofrequency catheter ablation of atrial fibrillation: A propensity score matching study

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
HN Pak ◽  
SY Yang ◽  
M Kim ◽  
HT Yu ◽  
TH Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Short Duration ◽  
High Power ◽  
Volume Index ◽  
Ablation Lesion ◽  
Efficacy And Safety ◽  
Clinical Recurrence

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Although high-power short-duration (HPSD) radiofrequency (RF) energy is commonly utilized in atrial fibrillation (AF) catheter ablation (CA), its efficacy, safety, and autonomic neural effects have not yet been evaluated in a large patient number. We compared HPSD-AFCA and conventional power (ConvP)-AFCA after propensity score matching. Methods Among 3,221 consecutive AF ablation patients, we included 1,720 patients (74.4% male, 59 ± 10 years old, 56.5% paroxysmal type) who underwent AFCA after propensity score matching: 430 in 50∼60W HPSD group vs. 1,290 in the ConvP group. We evaluated the procedural factors, complication risk, rhythm outcome, and 3-month heart rate variability (HRV) between the two groups and subgroups. Results Procedure times were significantly shorter in the HPSD group (p < 0.001), but the complication rate (p = 0.088) and the 3rd-month HRV did not differ between the two groups. At the 12-month follow-up, rhythm outcomes did not differ between the two groups (Overall, Log-rank p = 0.212; anti-arrhythmic drug off Log rank p = 0.246). These efficacy and safety outcomes were consistently similar regardless of the AF type or ablation lesion set. In the Cox regression analysis, the left atrium volume index measured by computed tomography (HR 1.009 [1.003-1.015]), p = 0.005) and extra-pulmonary vein triggers (HR 1.587 [1.033-2.440], p = 0.035) were independently associated with 1-year clinical recurrence, while the HPSD strategy was not (HR 1.188 [0.903-1.564], p = 0.218). Conclusions HPSD-AFCA significantly shortened the procedure time with similar rhythm outcomes, complication risks, and autonomic neural effects as ConvP-AFCA, regardless of the AF type or ablation lesion set. Abstract Figure.

scholarly journals Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching

Gut ◽  
2020 ◽  
Vol 70 (1) ◽  
pp. 76-84 ◽  
Author(s):  
Seung Won Lee ◽  
Eun Kyo Ha ◽  
Abdullah Özgür Yeniova ◽  
Sung Yong Moon ◽  
So Young Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Infection Rates ◽  
Entire Cohort ◽  
Increased Risk ◽  
The Relationship

ObjectiveThe adverse effects of proton pump inhibitors (PPIs) have been documented for pneumonia; however, there is no consensus regarding whether the use of PPIs might be harmful regarding the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this regard, we aimed to measure the potential associations of the current use of PPIs with the infection rates of COVID-19 among patients who underwent SARS-CoV-2 testing.DesignData were derived from a Korean nationwide cohort study with propensity score matching. We included 132 316 patients older than 18 years who tested for SARS-CoV-2 between 1 January and 15 May 2020. Endpoints were SARS-CoV-2 positivity (primary) and severe clinical outcomes of COVID-19 (secondary: admission to intensive care unit, administration of invasive ventilation or death).ResultsIn the entire cohort, there were 111 911 non-users, 14 163 current PPI users and 6242 past PPI users. After propensity score matching, the SARS-CoV-2 test positivity rate was not associated with the current or past use of PPIs. Among patients with confirmed COVID-19, the current use of PPIs conferred a 79% greater risk of severe clinical outcomes of COVID-19, while the relationship with the past use of PPIs remained insignificant. Current PPI use starting within the previous 30 days was associated with a 90% increased risk of severe clinical outcomes of COVID-19.ConclusionPatients taking PPIs are at increased risk for severe clinical outcomes of COVID-19 but not susceptible to SARS-CoV-2 infection. This suggests that physicians need to assess benefit–risk assessments in the management of acid-related diseases amid the COVID-19 pandemic.

scholarly journals Catheter Ablation for Atrial Fibrillation in HFpEF Patients – a Propensity‐Score matched Analysis

2021 ◽  
Author(s):  
Manuel Rattka ◽  
Anna Kühberger ◽  
Alexander Pott ◽  
Tilman Stephan ◽  
Karolina Weinmann ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Propensity Score

scholarly journals Outcome of contact force-guided radiofrequency catheter ablation or second generation cryoballoon ablation for paroxysmal atrial fibrillation: propensity score matched analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Ukita ◽  
A Kawamura ◽  
H Nakamura ◽  
K Yasumoto ◽  
M Tsuda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Propensity Score ◽  
Contact Force ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Second Generation ◽  
Late Recurrence ◽  
Cryoballoon Ablation ◽  
Atrial Tachyarrhythmia

Abstract Background Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA). Purpose The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF). Methods We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB. Results There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure). Conclusions Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA. Kaplan-Meier Curve Funding Acknowledgement Type of funding source: None

Abstract 205: New Onset Heart Failure and Adverse Ischemic Events Associated with Amiodarone and Dronedarone Use among Atrial Fibrillation Patients

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Gosia Sylwestrzak ◽  
Jinan Liu ◽  
Alan Rosenberg ◽  
Jeffrey White ◽  
John Barron ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Incidence Rate ◽  
Statistical Significance ◽  
Administrative Claims ◽  
Risk Of Death ◽  
Observational Cohort ◽  
New Onset

Background: Dronedarone is a non-iodinated form of amiodarone that may not cause some of serious adverse effects associated with amiodarone. However, it is less effective than amiodarone in maintaining normal sinus rhythm, and it does not improve success of electrical cardioversion. Additionally, dronedarone use has been associated with new onset or worsening of heart failure (HF), including a doubling of the risk of death in patients with symptomatic heart failure. We aimed to compare the incidence of newly diagnosed HF and HF hospitalizations among dronedarone and amiodarone users. Secondary outcomes of interest included rates of acute ischemic stroke (IS) and transient ischemic attack (TIA). Methods: This retrospective study utilized administrative claims data between 1/1/2007-9/30/2011 from the HealthCore Integrated Research Environment (HIRE ® ). Patients were required to have at least one claim for atrial fibrillation. Propensity score matching was employed to adjust for differences between the cohorts. Incidence rate of HF, HF hospitalizations, IS and TIA events were compared between matched cohorts using Poisson time-to-event model. Results: The cohort consisted of 6,013 amiodarone and 1,534 dronedarone patients. Dronedarone patients were younger, healthier per Deyo-Charlson Index (DCI) and CHADS2 score, and less likely to have underlying heart disease (all p-values<0.05). In the propensity score matching process 838 patients with comparable baseline characteristics were selected in each group. Median follow up was 552 days in the amiodarone cohort and 412 days in the dronedarone cohort. Among patients without HF history, new onset HF incidence rate was 34.6 per 100 person-year in amiodarone cohort and 19.1 per 100 person-year in dronedarone cohort (IRR=1.61, 95% CI: 1.30-2.01, p<0.01). The incidence rate for HF hospitalization was also higher in amiodarone patients-- 10.7 per 100 person-year against 7.8 per 100 person-year for dronedarone (IRR=1.39, 95% CI: 1.02-1.85, p=0.03). For IS, the incidence rate was 1.68 per 100 person-year in amiodarone vs. 0.84 in dronedarone but results did not reach statistical significance (IRR=1.91, 95% CI: 0.84-4.30, p=0.12); for TIA, it was 3.67 vs. 2.35 for amiodarone and dronedarone respectively (IRR=2.01, 95% CI: 1.14-3.57, p=0.02). Conclusions: In a propensity score matched observational cohort study, amiodarone use was associated with higher incidence rate of new onset HF, HF hospitalizations, and TIA as identified from claims. This finding differs from other clinical studies. Future observational cohort studies should incorporate medical record review for validation since information from claims might be insufficient to fully account for underlying patient risk status, or accurately determine if HF was new onset. Key words: amiodarone; dronedarone; atrial fibrillation; heart failure.

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