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Iliodromitis K, Tzeis S, Xintarakou A, Pyrgakis V, Zarifis I, Patsilinakos S, Draganigos A, Triposkiadis F, Hahalis G, Karanasios A, Goudevenos I, Michalis L, Karvounis C, Parthenakis F, Kanakakis I, Tousoulis D, Iliodromitis E, Vardas P. The burden of atrial fibrillation and heart failure in hospitalized patients: A real-world survey in a nationwide snapshot. Hellenic J Cardiol 2023; 74:18-23. [PMID: 37141945 DOI: 10.1016/j.hjc.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/09/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
PURPOSE Atrial fibrillation (AF) and heart failure (HF) are common and commonly coexisting cardiovascular diseases in hospitalized patients. We report the absolute number and interrelation between AF and HF, assess the daily burden of both diseases on the healthcare system, and describe the medical treatment in a real-world, nationwide conducted snapshot survey. METHODS A questionnaire was equally distributed to various healthcare institutions. Data on the baseline characteristics, prior hospitalizations, and medical treatments of all hospitalized patients with AF and HF at a predefined date were collected and analyzed. RESULTS Seventy-five cardiological departments participated in this multicenter Greek nationwide study. A total of 603 patients (mean age, 74.5 ± 11.4 years) with AF, HF, or the combination of both were nationwide admitted. AF, HF, and the combination of both were registered in 122 (20.2%), 196 (32.5%), and 285 (47.3%) patients, respectively. First-time hospital admission was recorded in 273 (45.7%) of 597 patients, whereas 324 (54.3%) of 597 patients had readmissions in the past 12 months. Of the entire population, 453 (75.1%) were on beta-blockers (BBs), and 430 (71.3%) were on loop diuretics. Furthermore, 315 patients with AF (77.4%) were on oral anticoagulation, of whom 191 (46.9%) were on a direct oral anticoagulant and 124 (30.5%) were on a vitamin K antagonist. CONCLUSION Hospitalized patients with AF and/or HF have more than one admission within a year. Coexistence of AF and HF is more common. BBs and loop diuretics are the most commonly used drugs. More than three-quarters of the patients with AF were on oral anticoagulation.
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Affiliation(s)
- Konstantinos Iliodromitis
- Clinic for Cardiology and Electrophysiology, Evangelical Hospital Hagen-Haspe, Germany & Hellenic Cardioresearch Foundation, Greece; School of Medicine, Witten/Herdecke University, Witten, Germany.
| | - Stylianos Tzeis
- Cardiology Department, Mitera General Hospital, Athens, Greece
| | | | - Vlasios Pyrgakis
- Cardiology Department, G. Gennimatas General Hospital, Athens, Greece
| | - Ioannis Zarifis
- Cardiology Department, Papanicolaou General Hospital, Thessaloniki, Greece
| | | | | | - Filippos Triposkiadis
- Department of Cardiology, Larissa University General Hospital, 413 34, Larissa, Greece
| | - George Hahalis
- Department of Cardiology Medical School, University Hospital of Patra, Patra, Greece
| | | | - Ioannis Goudevenos
- Department of Cardiology Medical School, University Hospital of Ioannina, Ioannina, Greece
| | - Lampros Michalis
- Department of Cardiology Medical School, University Hospital of Ioannina, Ioannina, Greece
| | - Charalampos Karvounis
- First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Fraggiskos Parthenakis
- Department of Cardiology, Medical School, University Hospital of Heraklion, Crete, Greece
| | | | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Panos Vardas
- Professor Emeritus of Cardiology, University of Crete, Former President of the European Society of Cardiology, Mitera General Hospital, HYGEIA Group, Greece & Hellenic Cardioresearch Foundation, Athens, Greece
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Lenarczyk R, Boveda S, Mansourati J, Russo V, Marijon E, Lane DA, Dagres N, Potpara TS. Peri-procedural management, implantation feasibility, and short-term outcomes in patients undergoing implantation of leadless pacemakers: European Snapshot Survey. Europace 2021; 22:833-838. [PMID: 32073116 DOI: 10.1093/europace/euaa023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/23/2020] [Indexed: 12/12/2022] Open
Abstract
The aim of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to assess procedural settings, safety measures, and short-term outcomes associated with implantation of leadless pacemakers (LLPM), across a broad range of tertiary European electrophysiology centres. An internet-based electronic questionnaire (30 questions) concerning implantation settings, peri-procedural routines, complications, and in-hospital patient outcomes was circulated to centres routinely implanting both LLPMs and transvenous pacemakers (TV-PM). The centres were requested to prospectively include consecutive patients implanted with either LLPMs or TV-PMs during the 10-week enrolment period. Overall, 21 centres from four countries enrolled 825 consecutive patients between November 2018 and January 2019, including 69 (9%) implanted with LLPMs. Leadless pacemakers were implanted mainly under local anaesthesia (69%), by an electrophysiologist (60%), in the electrophysiology laboratory (71%); 95% of patients received prophylactic antibiotics prior to implantation. Most patients on chronic oral anticoagulation were operated on-drug (35%), or during short-term (to 48 h) drug withdrawal (54%). Implantation was successful in 98% of patients and the only in-hospital procedure-related complication was groyne haematoma in one patient. This EHRA snapshot survey provides important insights into LLPM implantation routines and patient outcomes. These findings suggest that despite the unfavourable clinical profile of pacemaker recipients, LLPM implantation is associated with relatively low risk of complications and good short-term outcomes.
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Affiliation(s)
- Radosław Lenarczyk
- First Department of Cardiology and Angiology, Silesian Centre for Heart Disease, Curie-Sklodowskiej Str 9, 41-800 Zabrze, Poland
| | - Serge Boveda
- Cardiology - Heart Rhythm Management Department, Clinique Pasteur, 45 Avenue de Lombez, 31076 Toulouse, France.,Universiteit Ziekenhuis, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Jette Brussels, Belgium.,Paris University, PARCC-INSERM, 56 Rue Leblanc, 75908 Paris Cedex 15, France
| | - Jacques Mansourati
- Department of Cardiology, University Hospital of Brest, 9 Rue Félix le Dantec, 29200 Brest, France.,ORPHY, Université de Bretagne Occidentale, 3 Rue des Archives, 29238 Brest, France
| | - Vincenzo Russo
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Via Santa Maria di Costantinopoli 104, Napoli, NA 80138, Italy
| | - Eloi Marijon
- Paris University, PARCC-INSERM, 56 Rue Leblanc, 75908 Paris Cedex 15, France.,Cardiology Department, European Georges Pompidou Hospital, AP-HP, 20 Rue Leblanc, 75908 Paris Cedex 15, France
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.,Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Søndre Skovvej 15, Forskningens Hus, 9000 Aalborg, Denmark
| | - Nikolaos Dagres
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, dr Subotića Starijeg 8, 11000 Belgrad, Serbia.,Cardiology Clinic, Clinical Center of Serbia, Visegradska 26, 11000 Belgrade, Serbia
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