Abstract 13720: Safety of Same-day Discharge for Atrial Fibrillation Ablation: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Khawaja H Akhtar ◽  
Khadija N Sami ◽  
Muhammad H Khan ◽  
Ali H Jafry ◽  
Amna M Chaudhary ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vascular Complications ◽  
Cost Effective ◽  
Atrial Fibrillation Ablation ◽  
Forest Plot ◽  
Overnight Stay ◽  
Same Day Discharge ◽  
Ischemic Attack

Introduction: We evaluated the safety of same-day discharge in patients undergoing atrial fibrillation ablation procedure. Methods: A systematic search was conducted on 05/05/2020 by 2 independent researchers in MEDLINE, EMBASE and other databases for studies comparing the safety of same-day discharge versus overnight stay for patients undergoing atrial fibrillation ablation. No randomized controlled trials met the inclusion criteria, so observational studies were included in the analysis. Mantel-Haenszel risk ratios (random effects model) were calculated and for heterogeneity I 2 statistics were reported. Results: A total of 5 observational studies with 5018 patients were included. There was a non-statistically significant trend towards repeat 30 day hospital visits associated with same-day discharge as compared with overnight stay (RR=1.92, CI 0.44-8.32, p=0.39) (Figure-1). There were no differences between same-day discharge vs overnight stay in other outcomes including vascular complications (RR=1.24, CI 0.48-3.23), cardiac tamponade (RR=1.01, CI 0.15-6.60), stroke/transient ischemic attack/thromboembolic complications (RR=0.88, CI 0.05-16.19) and mortality (RR=1.03, CI 0.05=19.36) (Figure-1). Conclusion: Same day discharge after atrial fibrillation ablation is safe and has the potential to be a cost-effective strategy. Randomized trials are needed to validate these results. Figure-1: Forest plot of outcomes with same-day discharge vs overnight stay for patients undergoing atrial fibrillation ablation.

Comparison between same‐day discharge and overnight stay after atrial fibrillation ablation: systematic review and meta‐analysis

2021 ◽  
Author(s):  
Narut Prasitlumkum ◽  
Wisit Cheungpasitporn ◽  
Ronpichai Chokesuwattanaskul ◽  
Jakrin Kewcharoen ◽  
Nithi Tokavanich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Overnight Stay ◽  
Same Day Discharge

scholarly journals CHA2DS2-VASc risk factors as predictors of stroke after acute coronary syndrome: A systematic review and meta-analysis

2016 ◽  
Vol 7 (3) ◽  
pp. 264-274 ◽  
Author(s):  
Federico Guerra ◽  
Lorena Scappini ◽  
Alessandro Maolo ◽  
Gianluca Campo ◽  
Rita Pavasini ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Confidence Interval ◽  
Transient Ischemic Attack ◽  
Odds Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Odds Ratios ◽  
Coronary Syndrome ◽  
Ischemic Attack

Background: Stroke is a rare but serious complication of acute coronary syndrome. At present, no specific score exists to identify patients at higher risk. The aim of the present study is to test whether each clinical variable included in the CHA2DS2-VASc score retains its predictive value in patients with recent acute coronary syndrome, irrespective of atrial fibrillation. Methods: The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. All clinical trials and observational studies presenting data on the association between stroke/transient ischemic attack incidence and at least one CHA2DS2-VASc item in patients with a recent acute coronary syndrome were considered in the analysis. Atrial fibrillation diagnosis was also considered. Results: The whole cohort included 558,193 patients of which 7108 (1.3%) had an acute stroke and/or transient ischemic attack during follow-up (median nine months; 1st–3rd quartile 1–12 months). Age and previous stroke had the highest odds ratios (odds ratio 2.60; 95% confidence interval 2.21–3.06 and odds ratio 2.74; 95% confidence interval 2.19–3.42 respectively), in accordance with the two-point value given in the CHA2DS2-VASc score. All other factors were positively associated with stroke, although with lower odds ratios. Atrial fibrillation, while present in only 11.2% of the population, confirmed its association with an increased risk of stroke and/or transient ischemic attack (odds ratio 2.04; 95% confidence interval 1.71–2.44). Conclusions: All risk factors included in the CHA2DS2-VASc score are associated with stroke/ transient ischemic attack in patients with recent acute coronary syndrome, and retain similar odds ratios to what already seen in atrial fibrillation. The utility of CHA2DS2-VASc score for risk stratification of stroke in patients with acute coronary syndrome remains to be determined.

Meta-Analysis of Risk of Stroke or Transient Ischemic Attack With Dabigatran for Atrial Fibrillation Ablation

2014 ◽  
Vol 113 (7) ◽  
pp. 1173-1177 ◽  
Author(s):  
Partha Sardar ◽  
Ramez Nairooz ◽  
Saurav Chatterjee ◽  
Jørn Wetterslev ◽  
Joydeep Ghosh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Transient Ischemic Attack ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Ischemic Attack

scholarly journals B-AB05-03 A SAME DAY DISCHARGE STRATEGY AFTER ATRIAL FIBRILLATION ABLATION THAT IS OVERSEEN BY ALLIED HEALTH PROFESSIONALS CAN BE INITIATED SAFELY AND EFFECTIVELY

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S8
Author(s):  
Lauren Ashley Rousseau ◽  
Nicole M. Bourque ◽  
Tiffany Andrade ◽  
Megan E.B. Antonellis ◽  
Patrice Hoskins ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Professionals ◽  
Allied Health ◽  
Atrial Fibrillation Ablation ◽  
Allied Health Professionals ◽  
Same Day Discharge

Abstract 14648: Gender Differences in Procedural Complications Associated With Atrial Fibrillation Catheter Ablation: A Systematic Review and Meta-analysis of 244,353 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Martin L Campbell ◽  
John Larson ◽  
Talha Farid ◽  
Stacy Westerman ◽  
Michael S Lloyd ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Catheter Ablation ◽  
Gender Gap ◽  
Major Bleeding ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Vascular Complications ◽  
Increased Risk ◽  
Procedural Complications

Introduction: Women undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, studies have been underpowered to detect differences in rare complications such as stroke/transient ischemic attack (TIA) and procedural mortality. Methods: We performed a systematic review of databases (PubMed, World of Science, Embase) to identify studies published since 2010 reporting AFCA complications by gender. Six complications of interest were: 1) vascular/groin complications; 2) pericardial effusion/tamponade; 3) stroke/TIA; 4) permanent phrenic nerve injury; 5) major bleeding & 6) procedural mortality. For meta-analysis, random effects models were used when heterogeneity between studies was ≥ 50% (vascular complications, major bleeding) and fixed effects models for other endpoints. Results: Of 5716 citations, 19 studies met inclusion criteria, comprising 244,353 patients undergoing AFCA, of whom 33% were women. Women were older (65.3 ± 11.2 vs. 60.4 ± 13.2 years), more likely hypertensive (60.6 vs. 55.5%) and diabetic (18.3 vs. 16.5%) and had higher CHA 2 DS 2 -VASc scores (3.0 ± 1.8 vs. 1.4 ± 1.4) (p<0.0001 for all comparisons). The rates of all 6 complications were significantly higher in women (Table). However, despite statistically significant differences, the overall incidences of major complications were very low in both genders: stroke/TIA (women 0.51 vs. men 0.39%) and procedural mortality (women 0.25 vs. men 0.18%). Conclusion: Women experience significantly higher rates of AFCA complications. However, the incidence of major procedural complications is very low in both genders. The higher rate of complications in women may be partially attributable to older age and a higher prevalence of comorbidities at the time of ablation. More detailed studies are needed to better define the mechanisms of increased risk in women and to identify strategies for closing the gender gap.

scholarly journals Real-world adherence to oral anticoagulants in atrial fibrillation patients: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025102 ◽  
Author(s):  
Clara L Rodríguez-Bernal ◽  
Aníbal García-Sempere ◽  
Isabel Hurtado ◽  
Yared Santa-Ana ◽  
Salvador Peiró ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Real World ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Medication Possession Ratio ◽  
Essential Element ◽  
Study Endpoint ◽  
Mortality And Morbidity

IntroductionAtrial fibrillation (AF) is one of the leading causes of cerebrovascular mortality and morbidity. Oral anticoagulants (OACs) have been shown to reduce the incidence of cardioembolic stroke in patients with AF, adherence to treatment being an essential element for their effectiveness. Since the release of the first non-vitamin K antagonist oral anticoagulant, several observational studies have been carried out to estimate OAC adherence in the real world using pharmacy claim databases or AF registers. This systematic review aims to describe secondary adherence to OACs, to compare adherence between OACs and to analyse potential biases in OAC secondary adherence studies using databases.Methods and analysisWe searched on PubMed, SCOPUS and Web of Science databases (completed in 26 September 2018) to identify longitudinal observational studies reporting days’ supply adherence measures with OAC in patients with AF from refill databases or AF registers. The main study endpoint will be the percentage of patients exceeding the 80% threshold in proportion of days covered or the medication possession ratio. Two reviewers will independently screen potential studies and will extract data in a structured format. A random-effects meta-analysis will be carried out to pool study estimates. The risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies and we will also assess some study characteristics that could affect days’ supply adherence estimates.Ethics and disseminationThis systematic review using published aggregated data does not require ethics approval according to Spanish law and international regulations. The final results will be published in a peer-review journal and different social stakeholders, non-academic audiences and patients will be incorporated into the diffusion activities.PROSPERO registration numberCRD42018095646.

scholarly journals Impact of Contact Force Technology on Atrial Fibrillation Ablation: A Meta‐Analysis

2015 ◽  
Vol 4 (9) ◽  
Author(s):  
Mohammed Shurrab ◽  
Luigi Di Biase ◽  
David F. Briceno ◽  
Anna Kaoutskaia ◽  
Saleem Haj‐Yahia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation
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