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Hašková J, Kautzner J, Peichl P, Stojadinovič P, Aldhoon B, Štiavnický P, Borišincová E, Plášek J, Čihák R, Wichterle D. Ultrasound-guided femoral venipuncture for catheter ablation of atrial fibrillation. J Interv Card Electrophysiol 2025; 68:165-166. [PMID: 39259458 PMCID: PMC11832609 DOI: 10.1007/s10840-024-01918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/13/2024]
Affiliation(s)
- Jana Hašková
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
- Department of Medicine I, Palacky University Hospital, Olomouc, Czech Republic
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic.
- Department of Medicine I, Palacky University Hospital, Olomouc, Czech Republic.
| | - Petr Peichl
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Predrag Stojadinovič
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Bashar Aldhoon
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Peter Štiavnický
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Eva Borišincová
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Jiří Plášek
- Department of Medicine I, Palacky University Hospital, Olomouc, Czech Republic
- Centre for Research in Internal Medicine and Cardiovascular Diseases, The University of Ostrava, Ostrava, Czech Republic
| | - Robert Čihák
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
| | - Dan Wichterle
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958/9, Prague 4, 140 21, Czech Republic
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Ken-Opurum J, Srinivas SSS, Park S, Charland S, Revel A, Preblick R. Clinical and economic outcomes associated with use of anti-arrhythmic drugs versus ablation in atrial fibrillation. J Comp Eff Res 2023; 12:e230065. [PMID: 37387403 PMCID: PMC10508306 DOI: 10.57264/cer-2023-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
Aim: To evaluate the clinical and economic impact of antiarrhythmic drugs (AADs) compared with ablation both as individual treatments and as combination therapy without/with considering the order of treatment among patients with atrial fibrillation (AFib). Materials & methods: A budget impact model over a one-year time horizon was developed to assess the economic impact of AADs (amiodarone, dofetilide, dronedarone, flecainide, propafenone, sotalol, and as a group) versus ablation across three scenarios: direct comparisons of individual treatments, non-temporal combinations, and temporal combinations. The economic analysis was conducted in accordance with CHEERS guidance as per current model objectives. Results are reported as costs per patient per year (PPPY). The impact of individual parameters was evaluated using one-way sensitivity analysis (OWSA). Results: In direct comparisons, ablation had the highest annual medication/procedure cost ($29,432), followed by dofetilide ($7661), dronedarone ($6451), sotalol ($4552), propafenone ($3044), flecainide ($2563), and amiodarone ($2538). Flecainide had the highest costs for long-term clinical outcomes ($22,964), followed by dofetilide ($17,462), sotalol ($15,030), amiodarone ($12,450), dronedarone ($10,424), propafenone ($7678) and ablation ($9948). In the non-temporal scenario, total costs incurred for AADs (group) + ablation ($17,278) were lower compared with ablation alone ($39,380). In the temporal scenario, AADs (group) before ablation resulted in PPPY cost savings of ($22,858) compared with AADs (group) after ablation ($19,958). Key factors in OWSA were ablation costs, the proportion of patients having reablation, and withdrawal due to adverse events. Conclusion: Utilization of AADs as individual treatment or in combination with ablation demonstrated comparable clinical benefits along with costs savings in patients with AFib.
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Cacioppo F, Schwameis M, Schuetz N, Oppenauer J, Schnaubelt S, Simon A, Lutnik M, Gupta S, Roth D, Herkner H, Spiel AO, Laggner AN, Domanovits H, Niederdoeckl J. Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116606. [PMID: 35682190 PMCID: PMC9180807 DOI: 10.3390/ijerph19116606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022]
Abstract
Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the cardioversion success of ibutilide and amiodarone in patients with post-ablation atrial tachyarrhythmia. We included all episodes of post-ablation atrial tachyarrhythmia in patients treated with either intravenous ibutilide or amiodarone at an academic emergency department from 2010 to 2018. The primary endpoint was the conversion to sinus rhythm. The conversion rates were stratified by arrhythmia type, and multivariable cluster-adjusted logistic regression was used to estimate the effect of ibutilide and amiodarone on cardioversion success, given as the odds ratio (OR) with 95% confidence intervals (95% CI). In total, 109 episodes of 72 patients were analyzed. The conversion rates were 37/49 (76%) for ibutilide and 16/60 (27%) for amiodarone. Compared to amiodarone, ibutilide was associated with higher odds of conversion (multivariable cluster-adjusted OR 5.6, 95% CI 1.3–24.3). The cardioversion success of ibutilide was the highest in atrial flutter (crude OR 19.5, 95% CI 3.4–112.5) and focal atrial tachycardia (crude OR 8.3, 95% CI 1.5–47.2), but it was less pronounced in atrial fibrillation (crude OR 4.5, 95% CI 1.2–17.2). Randomized trials are warranted to confirm our findings.
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Affiliation(s)
- Filippo Cacioppo
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Michael Schwameis
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Nikola Schuetz
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Julia Oppenauer
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Sebastian Schnaubelt
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Alexander Simon
- Clinic Ottakring, Department of Emergency Medicine, Montleartstraße 37, 1160 Vienna, Austria;
| | - Martin Lutnik
- Medical University of Vienna, Department of Clinical Pharmacology, Waehringer Guertel 18-20, 1090 Vienna, Austria;
| | - Sophie Gupta
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Dominik Roth
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Harald Herkner
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Alexander Oskar Spiel
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
- Clinic Ottakring, Department of Emergency Medicine, Montleartstraße 37, 1160 Vienna, Austria;
- Correspondence:
| | - Anton Norbert Laggner
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Hans Domanovits
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
| | - Jan Niederdoeckl
- Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria; (F.C.); (M.S.); (N.S.); (J.O.); (S.S.); (S.G.); (D.R.); (H.H.); (A.N.L.); (H.D.); (J.N.)
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