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du Fay de Lavallaz J, Badertscher P, Ghannam M, Oral H, Jongnarangsin K, Boveda S, Madeira M, Gupta D, Ding WY, Providencia R, MacLean E, Tokuda M, Tokutake K, Reichlin T, Zhang F, Scherr D, Popa MA, Huang H, Pavlović N, Peigh G, Li X, Davtyan K, Kosmidou I, Anselmino M, Jain S, Squara F, Nof E, Matta M, Kojodjojo P, Khoueiry Z, Knecht S, Krisai P, Sticherling C, Kühne M. Severe Periprocedural Complications After Ablation for Atrial Fibrillation: An International Collaborative Individual Patient Data Registry. JACC Clin Electrophysiol 2024:S2405-500X(24)00258-5. [PMID: 38819347 DOI: 10.1016/j.jacep.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Catheter ablation for atrial fibrillation (AF) including pulmonary vein isolation and possibly further substrate ablation is the most common electrophysiological procedure. Severe complications are uncommon, but their detailed assessment in a large worldwide cohort is lacking. OBJECTIVES The aim of this study was to determine the incidence of periprocedural severe complications and to provide a detailed characterization of the diagnostic evaluation and management of these complications in patients undergoing AF ablation. METHODS Individual patient data were collected from 23 centers worldwide. Limited data were collected for all patients who underwent catheter ablation, and an expanded series of data points were collected for patients who experienced severe complications during periprocedural follow-up. Incidence, predictors, patient characteristics, management details, and overall outcomes of patients who experienced ablation-related complications were investigated. RESULTS Data were collected from 23 participating centers at which 33,879 procedures were performed (median age 63 years, 30% women, 71% radiofrequency ablations). The incidence of severe complications (n = 271) was low (tamponade 6.8‰, stroke 0.97‰, cardiac arrest 0.41‰, esophageal fistula 0.21‰, and death 0.21‰). Age, female sex, a dilated left atrium, procedure duration, and the use of radiofrequency energy were independently associated with the composite endpoint of all severe complications. Among patients experiencing tamponade, 13% required cardiac surgery. Ninety-three percent of patients with complications were discharged directly home after a median length of stay of 5 days (Q1-Q3: 3-7 days). CONCLUSIONS This large worldwide collaborative study highlighted that tamponade, stroke, cardiac arrest, esophageal fistula, and death are rare after AF ablation. Older age, female sex, procedure duration, a dilated left atrium, and the use of radiofrequency energy were associated with severe complications in this multinational cohort. One in 8 patients with tamponade required cardiac surgery.
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Affiliation(s)
| | | | | | - Hakan Oral
- University of Michigan, Ann Arbor, Michigan, USA
| | | | - Serge Boveda
- Clinique Pasteur, Toulouse, France; Brussels University VUB, Brussels, Belgium
| | - Marta Madeira
- Clinique Pasteur, Toulouse, France; Centro Hospitalar Universitário de São João, Universidade de Coimbra, Coimbra, Portugal
| | - Dhiraj Gupta
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Wern Yew Ding
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | - Rui Providencia
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Edward MacLean
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Institute of Health Informatics Research, University College London, London, United Kingdom
| | | | | | | | - Fengxiang Zhang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | | - Miruna A Popa
- German Heart Center, Technical University of Munich, Munich, Germany
| | - Henry Huang
- Rush University Medical Center, Chicago, Illinois, USA
| | | | - Graham Peigh
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Xiaorong Li
- Shanghai Tongji University Hospital, Shanghai, China
| | - Karapet Davtyan
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Ioanna Kosmidou
- Memorial Sloan Kettering Cancer Center and Weill Cornell College of Medicine, New York, New York, USA
| | | | - Sandeep Jain
- University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA
| | | | - Eyal Nof
- Sheba Medical Center, Ramat Gan, Israel
| | - Mario Matta
- Città Della Salute e Della Scienza di Torino, Torino, Italy
| | | | | | - Sven Knecht
- University Hospital Basel, Basel, Switzerland
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2
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Ortoleva J, Homoud M, Shapeton AD. Heart Failure With Reduced Ejection Fraction: Don't Wait, Ablate! J Cardiothorac Vasc Anesth 2024; 38:355-357. [PMID: 38042743 DOI: 10.1053/j.jvca.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Jamel Ortoleva
- Department of Anesthesiology, Boston Medical Center, Boston, MA
| | - Munther Homoud
- Section of Pacing and Electrophysiology, Tufts Medical Center, Boston, MA
| | - Alexander D Shapeton
- Department of Anesthesia, Critical Care and Pain Medicine, Boston Veterans Affairs Healthcare System, Boston, MA; Tufts University School of Medicine, Boston, MA.
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Mol D, van der Stoel MD, Balt JC, Bhagwandien RE, Blaauw Y, van Dessel PFHM, van Driel VJHM, Driessen AHG, Elvan A, Hassink RJ, Kemme MJB, Kraaier K, Kuijt WJ, Luermans JGLM, van der Voort PH, Westra SW, de Groot JR, de Jong JSSG. Low 30-day Mortality after Atrial Fibrillation Ablation; Results from the Netherlands Heart Registration: NHR-AF Mortality Study. Can J Cardiol 2022; 38:1616-1618. [PMID: 35709933 DOI: 10.1016/j.cjca.2022.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/19/2022] Open
Abstract
This study presents the 30-day mortality of patients who underwent atrial fibrillation (AF) ablation between 2013 - 2020 and were registered in the Netherlands Heart Registration. In total, 30,197/30,238 (99.9%) patients were analyzed. Fifteen (0.05%) died within 30 days. Nine deaths were considered procedurally related, four were considered non-procedural related, and in two patients the cause of death was unknown.
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Affiliation(s)
- Daniel Mol
- OLVG, Department of Cardiology, Amsterdam, The Netherlands; Amsterdam University Medical Centers/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, The Netherlands.
| | | | - Jippe C Balt
- St Antonius, Department of Cardiology, Nieuwegein, The Netherlands
| | - Rohit E Bhagwandien
- Erasmus Medical Center, Department of Cardiology, Rotterdam, The Netherlands
| | - Yuri Blaauw
- University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | | | | | - Antoine H G Driessen
- Amsterdam University Medical Centers/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, The Netherlands
| | - Arif Elvan
- Isala, Department of Cardiology, Zwolle, The Netherlands
| | - Rutger J Hassink
- University Medical Center Utrecht, Department of Cardiology, Utrecht, The Netherlands
| | - Michiel J B Kemme
- Amsterdam University Medical Centers/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, The Netherlands
| | - Karin Kraaier
- Medical Center Leeuwarden, Department of Cardiology, Leeuwarden, The Netherlands
| | | | - Justin G L M Luermans
- Maastricht University Medical Center, Department of Cardiology, Maastricht, The Netherlands
| | - Pepijn H van der Voort
- Catharina Hospital, Department of Cardiology and Cardiac Surgery, Eindhoven, The Netherlands
| | - Sjoerd W Westra
- Radboud University Medical Center, Department of Cardiology, Nijmegen, The Netherlands
| | - Joris R de Groot
- Amsterdam University Medical Centers/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, The Netherlands
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4
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de Groot JR, Linz D. Arterial stiffness and atrial fibrillation recurrence: another risk marker or a call for better management of concomitant disease? Neth Heart J 2022; 30:187-189. [PMID: 35258798 PMCID: PMC8941029 DOI: 10.1007/s12471-022-01678-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- J R de Groot
- Department of Cardiology, Heart Centre, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
| | - D Linz
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Faculty of Health, Medicine and Life Sciences, Maastricht University and Maastricht University Medical Centre+, Maastricht, The Netherlands.,Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
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Mol D, Mulder MJ, Veenstra R, Allaart CP, Hof IE, Kemme MJB, Khan M, Kimman GJP, Mairuhu G, de Ruiter GS, Tahapary GJM, de Groot JR, de Jong JSSG. Strategies for Repeat Ablation for Atrial Fibrillation: A Multicentre Comparison of Non-Pulmonary Vein versus Pulmonary Vein Target Ablation. J Cardiovasc Electrophysiol 2022; 33:885-896. [PMID: 35257441 PMCID: PMC9315029 DOI: 10.1111/jce.15441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Abstract
Introduction Approximately 18% of patients with atrial fibrillation (AF) undergo a repeat ablation within 12 months after their index ablation. Despite the high prevalence, comparative studies on nonpulmonary vein (PV) target strategies in repeat AF ablation are scarce. Here, we describe 12 months efficacy of non‐PV and PV target ablations as a repeat ablation strategy. Methods A multicentre retrospective, descriptive study was conducted with data of 280 patients who underwent repeat AF ablation. The ablation strategy for repeat ablation was at the operators' discretion. Non‐PV target ablation (n = 140) included PV reisolation, posterior wall isolation, mitral line, roofline, and/or complex fractionated atrial electrogram ablation. PV target ablation (n = 140), included reisolation and/or wide atrium circumferential ablation. Patients' demographics and rhythm outcomes during 12 months follow‐up were analyzed. Results At 12 months, more atrial tachyarrhythmias were observed in the non‐PV target group (48.6%) compared to the PV target group (29.3%, p = .001). Similarly, a significantly higher AF and atrial tachycardia (AT) recurrence rate was observed after non‐PV target ablation compared to PV target ablation (36.4% vs. 22.1% and 22.9% vs. 10.7%). After adjustment, a significantly higher risk of AT recurrence remained in the non‐PV target group. Both groups significantly de‐escalated antiarrhythmic drug use; de‐escalation was more profound after PV target ablation. Patients with isolated PVs during non‐PV target ablation had a significantly higher risk for AF recurrence than those with reconnected PVs. Conclusion Compared to PV target ablation, non‐PV target repeat ablation did not improve outcomes after 12 months and was independently associated with an increased risk for AT recurrences.
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Affiliation(s)
- Daniel Mol
- OLVG, department of cardiology, Amsterdam, the Netherlands.,Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands
| | - Mark J Mulder
- Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands
| | - Rob Veenstra
- OLVG, department of cardiology, Amsterdam, the Netherlands
| | - Cor P Allaart
- Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands
| | - Irene E Hof
- OLVG, department of cardiology, Amsterdam, the Netherlands
| | - Michiel J B Kemme
- Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands
| | - Muchtiar Khan
- OLVG, department of cardiology, Amsterdam, the Netherlands
| | - Geert-Jan P Kimman
- OLVG, department of cardiology, Amsterdam, the Netherlands.,Noord-West Hospital group, department of Cardiology, Alkmaar, the Netherlands
| | - Gideon Mairuhu
- OLVG, department of cardiology, Amsterdam, the Netherlands.,Flevohospital, department of Cardiology, Almere, the Netherlands
| | | | - Giovanni J M Tahapary
- Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands.,Noord-West Hospital group, department of Cardiology, Alkmaar, the Netherlands
| | - Joris R de Groot
- Amsterdam University Medical Centres, department of Cardiology, Amsterdam, the Netherlands
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Mol D, Renskers L, Balt JC, Bhagwandien RE, Blaauw Y, van Driel VJHM, Driessen AHG, Elvan A, Folkeringa R, Hassink R, Hooft van Huysduynen B, Luermans JGLM, Stevenhagen JY, van der Voort PH, Westra SW, de Groot JR, de Jong JSSG. Persistent Phrenic Nerve Palsy after Atrial Fibrillation Ablation: Follow-up Data from the Netherlands Heart Registration. J Cardiovasc Electrophysiol 2022; 33:559-564. [PMID: 35040534 PMCID: PMC9303579 DOI: 10.1111/jce.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/07/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022]
Abstract
Background Persistent phrenic nerve palsy (PNP) is an established complication of atrial fibrillation (AF) ablation, especially during cryoballoon and thoracoscopic ablation. Data on persistent PNP reversibility is limited because most patients recover <24 h. This study aims to investigate persistent PNP recovery, freedom of PNP‐related symptoms after AF ablation and identify baseline variables associated with the occurrence and early PNP recovery in a large nationwide registry study. Methods In this study, we used data from the Netherlands Heart Registration, comprising data from 9549 catheter and thoracoscopic AF ablations performed in 2016 and 2017. PNP data was available of 7433 procedures, and additional follow‐up data were collected for patients who developed persistent PNP. Results Overall, the mean age was 62 ± 10 years, and 67.7% were male. Fifty‐four (0.7%) patients developed persistent PNP and follow‐up was available in 44 (81.5%) patients. PNP incidence was 0.07%, 0.29%, 1.41%, and 1.25%, respectively for patients treated with conventional‐RF, phased‐RF, cryoballoon, and thoracoscopic ablation respectively. Seventy‐one percent of the patients fully recovered, and 86% were free of PNP‐related symptoms after a median follow‐up of 203 (113–351) and 184 (82–359) days, respectively. Female sex, cryoballoon, and thoracoscopic ablation were associated with a higher risk to develop PNP. Patients with PNP recovering ≤180 days had a larger left atrium volume index than those with late or no recovery. Conclusion After AF ablation, persistent PNP recovers in the majority of patients, and most are free of symptoms. Female patients and patients treated with cryoballoon or thoracoscopic ablation are more prone to develop PNP.
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Affiliation(s)
- Daniel Mol
- OLVG, Department of Cardiology, Amsterdam, the Netherlands.,Amsterdam University Medical Centres/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, the Netherlands
| | | | - Jippe C Balt
- St. Antonius, Department of Cardiology, Nieuwegein, the Netherlands
| | - Rohit E Bhagwandien
- Erasmus Medical Centre, Department of Cardiology, Rotterdam, the Netherlands
| | - Yuri Blaauw
- University Medical Centre Groningen, Department of Cardiology, Groningen, the Netherlands
| | | | - Antoine H G Driessen
- Amsterdam University Medical Centres/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, the Netherlands
| | - Arif Elvan
- Isala, Department of Cardiology, Zwolle, the Netherlands
| | - Richard Folkeringa
- Medical Centre Leeuwarden, Department of Cardiology, Leeuwarden, the Netherlands
| | - Rutger Hassink
- University Medical Centre Utrecht, Department of Cardiology, Utrecht, the Netherlands
| | | | - Justin G L M Luermans
- Maastricht University Medical Centre, Department of Cardiology, Maastricht, the Netherlands
| | | | - Pepijn H van der Voort
- Catharina Hospital, Department of Cardiology and Cardiac Surgery, Eindhoven, the Netherlands
| | - Sjoerd W Westra
- Radboud University Medical Centre, Department of Cardiology, Nijmegen, the Netherlands
| | - Joris R de Groot
- Amsterdam University Medical Centres/University of Amsterdam, Department of Cardiology and Cardiac Surgery, Amsterdam, the Netherlands
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- OLVG, Department of Cardiology, Amsterdam, the Netherlands
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7
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Pott A, Wirth H, Teumer Y, Weinmann K, Baumhardt M, Schweizer C, Markovic S, Buckert D, Bothner C, Rottbauer W, Dahme T. Predicting Phrenic Nerve Palsy in Patients Undergoing Atrial Fibrillation Ablation With the Cryoballoon-Does Sex Matter? Front Cardiovasc Med 2022; 8:746820. [PMID: 34970602 PMCID: PMC8712427 DOI: 10.3389/fcvm.2021.746820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Phrenicus nerve palsy (PNP) is a typical complication during pulmonary vein isolation (PVI) using the cryoballoon with the ominous potential to counteract the clinical benefit of restored sinus rhythm. According to current evidence incidence of PNP is about 5–10% of patients undergoing Cryo-PVI and is more frequent during ablation of the RSPV compared to the RIPV. However, information on patient specific characteristics predicting PNP and long-term outcome of patients suffering from this adverse event is sparse. Aim of the Study: To evaluate procedural and clinical characteristics of AF patients with PNP during cryoballoon PVI compared to patients without PNP. Methods and Results: Between 2013 and 2019 we included 632 consecutive AF patients undergoing PVI with the cryoballoon in our study. 84/632 (13.3%) patients experienced a total number of 89 PNP during the ablation procedure. 75/89 (84%) cryothermal induced PNP recovered until the end of the procedure (transient PNP, tPNP), whereas 14/89 (16%) PNP hold beyond the end of the procedure (non-transient PNP, ntPNP). Using multivariate logistic regression, we found that sex and BMI are strong and independent predictors of cryothermal induced non-transient PNP during cryoballoon PVI with an odds ratio of 3.9 (CI: 95%, 1.1–14.8, p = 0.04) for female gender. Interestingly, all patients (14/14, 100%) with a non-transient PNP experienced complete PNP resolution after a mean recovery time of 68 ± 79 days. Conclusion: Our data indicate for the first time, that female sex and lower BMI are independent predictors for non-transient PNP caused by cryoballoon PVI. Fortunately, during follow up all PNP patients resolved completely with a median recovery time of 35 days.
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Affiliation(s)
- Alexander Pott
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Hagen Wirth
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Yannick Teumer
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Karolina Weinmann
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Michael Baumhardt
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | | | - Sinisa Markovic
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Dominik Buckert
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Carlo Bothner
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
| | | | - Tillman Dahme
- Department of Medicine II, Ulm University Medical Center, Ulm, Germany
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8
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Thoracoscopic surgical atrial fibrillation ablation in patients with an extremely enlarged left atrium. J Interv Card Electrophysiol 2021; 64:469-478. [PMID: 34529207 PMCID: PMC9399050 DOI: 10.1007/s10840-021-01056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/19/2021] [Indexed: 11/25/2022]
Abstract
Purpose Efficacy of pulmonary vein isolation (PVI) for atrial fibrillation (AF) decreases as left atrial (LA) volume increases. However, surgical AF ablation with unknown efficacy is being performed in patients with a giant LA (GLA). We determined efficacy of thoracoscopic AF ablation in patients with compared to without a GLA. Methods Patients underwent thoracoscopic PVI with additional left atrial ablations lines (in persistent AF) and were prospectively followed up. GLA was defined as LA volume index (LAVI) ≥ 50 ml/m2. Follow-up was performed with ECGs and 24-h Holters every 3 months. After a 3-month blanking period, all antiarrhythmic drugs were discontinued. The primary outcome was freedom of any atrial tachyarrhythmia ≥ 30 s during 2 years of follow-up. Results At baseline, 68 (15.4%) patients had a GLA (LAVI: 56.7 [52.4–62.8] ml/m2), while 374 (84.6%) had a smaller LA (LAVI: 34.8 [29.2–41.3] ml/m2). GLA patients were older (61.9 ± 6.9 vs 59.4 ± 8.8 years, p = 0.02), more often diagnosed with persistent AF (76.5% vs 58.6%, p = 0.008). Sex was equally distributed (with approximately 25% females). GLA patients had more recurrences compared to non-GLA patients at 2-year follow-up (42.6% vs 57.2%, log rank p = 0.02). Freedom of AF was 69.0% in non-GLA paroxysmal AF patients compared to 43.8–49.3% in a combined group of GLA and/or persistent AF patients(log rank p < 0.001). Furthermore, freedom was 62.4% in non-GLA male patients, compared to 43.8–47.4 in a combined group of GLA and/or female sex(log rank p = 0.02). Conclusion Thoracoscopic AF ablation is an effective therapy in a substantial part of GLA patients. Thoracoscopic AF ablation may serve as a last resort treatment option in these patients.
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9
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Nelson JA, Gue YX, Christensen JM, Lip GYH, Ramakrishna H. Analysis of the ESC/EACTS 2020 Atrial Fibrillation Guidelines With Perioperative Implications. J Cardiothorac Vasc Anesth 2021; 36:2177-2195. [PMID: 34130901 DOI: 10.1053/j.jvca.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/11/2022]
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, with an individual lifetime risk of approximately 37% in the United States. Broadly defined as a supraventricular tachyarrhythmia with disorganized atrial activation, AF results in an increased risk of stroke, heart failure, valvular heart disease, and impaired quality of life, and confers a significant burden on the health of individuals and society. AF in the perioperative setting is common and a significant source of perioperative morbidity and mortality worldwide. The latest iteration of the European Society of Cardiology AF guidelines published in 2020 provide the clinician a valuable road map for the management of this arrythmia. This expert review will comprehensively analyze the 2020 European Society of Cardiology guidelines and provide perioperative management tools for the clinician.
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Affiliation(s)
- James A Nelson
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Ying X Gue
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Jon M Christensen
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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Jordaens L, de Asmundis C, Chierchia GB. On the Dutch Registry of catheter ablation of atrial fibrillation. Europace 2021; 23:1331. [PMID: 33779705 DOI: 10.1093/europace/euab067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luc Jordaens
- Department of Cardiology, Faculty of Medicine, University Ghent, Cornelis Heymanslaan 10, 9000 Ghent, Belgium.,University Hospital Brussels, Brussels, Belgium
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11
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Mol D, de Jong JSSG, de Groot JR. On the Dutch Registry of catheter ablation of atrial fibrillation: Authors' reply. Europace 2021; 23:1331-1332. [PMID: 33779709 DOI: 10.1093/europace/euab068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/03/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daniel Mol
- Department of Cardiology, OLVG, Oosterpark 9, 1091 AC Amsterdam, the Netherlands; and.,Department of Cardiology and Cardiac Surgery, Amsterdam University Medical Centres/University of Amsterdam, Amsterdam, the Netherlands
| | - Jonas S S G de Jong
- Department of Cardiology, OLVG, Oosterpark 9, 1091 AC Amsterdam, the Netherlands; and
| | - Joris R de Groot
- Department of Cardiology and Cardiac Surgery, Amsterdam University Medical Centres/University of Amsterdam, Amsterdam, the Netherlands
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