Abstract 072: Impact of Chronic Diabetes on Periprocedural Outcomes Among Patient With Atrial Fibrillation and Flutter Who Underwent Radiofrequency Catheter Ablation Therapy (RFA). Report From the NIS 2014.

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Samson E Alliu ◽  
Adeyinka Adejumo ◽  
Modupeolowa Durojaiye ◽  
Akintoye Emmanuel ◽  
Lawrence Wolf ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Perioperative Complications ◽  
Vascular Complications ◽  
Cardiac Complications ◽  
Peripheral Vascular ◽  
Respiratory Complications ◽  
Ablation Therapy ◽  
Teaching Status ◽  
Atrial Fibrillation And Flutter

Background: Diabetes has been associated with complications and poor perioperative outcomes. In Radiofrequency catheter ablation - therapy of choice for drug refractory atrial fibrillation and flutter, association between diabetes and procedural complications are less documented. Objectives: To examine if there is a difference in perioperative complications in patients with chronic diabetes who underwent RFA for atrial fibrillation/flutter when compared with non-diabetics. Methods: We selected patients > 45 years from the National Inpatient Survey data 2014. We identified 8356 patients (69.6 ± 9.1yrs) who underwent catheter ablation. Logistic regression analyses were performed to investigate the difference in perioperative complications (hemorrhage, cardiac perforation, cardiac complications, respiratory complications, peripheral vascular complications, stroke and in-hospital mortality) between diabetics and non-diabetics. All models were adjusted for age, gender, race, residential income, insurance, co-morbidities, hospital bed size, hospital location/teaching status, hospital region, length of stay and median household income. Results: Among our selected 8356 patients, 5777(69.1%) were non-diabetics, 2203(26.4%) had uncomplicated diabetes and 376 (4.5%) complicated diabetes. Overall there were 634 events (240 hemorrhages, 56 perforations, 163 cardiac complications, 43 respiratory complications, 12 strokes, 40 peripheral vascular complications and 80 in-hospital death. Rates of complications were the same among diabetes and non-diabetics. In the multivariate models, the odds of complications remain statistically non-significant across all the groups. However, among all the patients who underwent RFA, there is an increased odds of hemorrhage among patients with Medicare insurance versus private insurance (OR 1.73 95%CI 1.11-2.70), peripheral vascular complications among hospitals in the south (OR 3.35 95%CI 1.30-9.62), respiratory complications among patients with CHF (4.60 95%CI 1.68-12.60), death among patients with renal failure (OR 2.22 95%CI 1.32-3.73) and hospitals in the south (2.55 95% CI 1.08-6.0) and west (OR 3.23 95%CI 1.25-8.3) compared to the northeast. Odds of stroke were less among both urban non-teaching (OR 0.02 95%CI 0.01 - 0.34) and teaching hospital (OR 0.05 95%CI 0.01-0.36) when compared to rural hospital. Conclusions: RFA has a similar procedural safety in diabetics when compared to non-diabetic patients. It remains a safe procedure in diabetics with drug-refractory atrial fibrillation and flutter. Renal failure, CHF, type of Insurance, hospital location and teaching status are predictors of complications after RFA.

Effectiveness of a strategy to reduce major vascular complications from catheter ablation of atrial fibrillation

2011 ◽  
Vol 30 (3) ◽  
pp. 211-215 ◽  
Author(s):  
Fnu Abhishek ◽  
Edwin Kevin Heist ◽  
Conor Barrett ◽  
Stephan Danik ◽  
Dan Blendea ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Vascular Complications

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 Anticoagulant therapy in catheter ablation of atrial fibrillation and flutter

2021 ◽  
Vol 20 (5) ◽  
pp. 2974
Author(s):  
M. V. Serova ◽  
D. A. Andreev ◽  
M. I. Chashkina ◽  
Z. K. Salpagarova
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Anticoagulant Therapy ◽  
Randomized Trials ◽  
Web Of Science ◽  
Evidence Base ◽  
Thromboembolic Events ◽  
Practical Information ◽  
Atrial Fibrillation And Flutter ◽  
Current Guidelines

Catheter ablation (CA) of atrial fibrillation and flutter is associated with a high risk of both perioperative thromboembolic events and bleeding. Adequate anticoagulation is imperative to reduce the risk of complications. The aim of this review was to analyze modern approaches to anticoagulant therapy for CA of atrial fibrillation and flutter, as well as provide practical information based on a comparison of current guidelines and evidence base. The search for literature sources on anticoagulant therapy in CA was carried out in the PubMed, Scopus, Web of Science databases. The results of key randomized trials and meta-analyzes are presented, and a comparison of current Russian and international guidelines is given. Unresolved issues requiring further research are discussed.

scholarly journals Influence of Sleep-Disorder Breathing on Recurrence in Patients with Catheter Ablation Therapy for Atrial Fibrillation

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PJ1_023
Author(s):  
Kensuke Fujiwara ◽  
Koji Abe ◽  
Chizuru Sato ◽  
Satoru Komura ◽  
Atsushi Iwasa
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sleep Disorder ◽  
Sleep Disorder Breathing ◽  
Ablation Therapy

scholarly journals Catheter Ablation Therapy for Atrial Fibrillation

2007 ◽  
Vol 71 (SupplementA) ◽  
pp. A82-A89 ◽  
Author(s):  
Yoshito Iesaka ◽  
Kiyoshi Otomo ◽  
Yasutoshi Nagata ◽  
Kikuya Uno
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ablation Therapy

scholarly journals Racial Disparities in the Use of Catheter Ablation for Atrial Fibrillation and Flutter

2014 ◽  
Vol 37 (12) ◽  
pp. 733-737 ◽  
Author(s):  
Leonardo Tamariz ◽  
Alexis Rodriguez ◽  
Ana Palacio ◽  
Hua Li ◽  
Robert Myerburg
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Racial Disparities ◽  
Atrial Fibrillation And Flutter

MO749CATHETER ABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND ON DIALYSIS - A META-ANALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Isaac Chung ◽  
Yasir Khan ◽  
Rao Kondapally ◽  
Manav Sohal ◽  
Debasish Banerjee
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Catheter Ablation ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Recurrence Rates ◽  
Ablation Therapy ◽  
Abnormal Metabolism ◽  
Af Recurrence

Abstract Background and Aims Atrial fibrillation (AF) is common in chronic kidney disease (CKD) patients and is difficult to treat with antiarrhythmics and anticoagulants due to abnormal metabolism and increased side effects. Catheter ablation if successful may be a safer alternative. This review evaluates the efficacy of catheter ablation therapy in CKD and haemodialysis (HD) patients. Method MEDLINE and Embase databases were searched with the following search terms: “(atrial fibrillation AND (chronic kidney disease OR renal failure OR renal function OR dialysis) AND ablation)” for journal articles of any language until December 2020. Two authors abstracted the data independently. Risk ratios were derived using random-effects meta-analysis. Results Of the initially identified 520 studies, 5 and 3 observational studies on CKD and HD patients respectively were found reporting AF recurrence rates. During a mean (SD) follow-up of 25.5 (9.8) months, CKD patients had a higher risk of AF recurrence compared to patients without CKD (RR 2.34, 95% CI 1.36-4.02, p&lt;0.01). The heterogenicity test showed there were significant differences between individual studies (I2 = 91%, 95% CI 82.2%-95.6%, p&lt;0.01). In a mean (SD) follow-up of 40.3 (20.8) months, HD patients may be at a higher risk of AF recurrence compared to healthy non-dialysis AF patients (RR 1.21, 95% CI 0.64-2.30, p=0.55). Heterogeneity analysis showed the studies were heterogeneous (I2 92.3%, 95% CI 80.8%-96.9%, p &lt;0.01). Conclusion Our meta-analysis suggests patients with CKD and patients on HD are more likely to have AF recurrences after catheter ablation compared to AF patients who are otherwise healthy. However, more robust evidence from randomized controlled trials comparing catheter ablation and pharmaceutical rhythm therapy are urgently needed to guide therapy in this difficult to treat population.

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