Outcomes of atrial fibrillation ablation in community hospitals with and without onsite cardiothoracic surgery availability.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-09-26 DOI:10.1007/s10840-024-01920-w

Olatunde Ola, S Michael Gharacholou, Abhishek J Deshmukh, Arturo M Valverde, Christopher G Scott, Alexander T Lee, Freddy Del-Carpio Munoz

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引用次数: 0

Abstract

Background: Limited data exist on outcomes of atrial fibrillation (AF) catheter ablation based on hospital setting and, specifically, the availability of onsite cardiothoracic surgery (CTS). We aimed to describe the characteristics and outcomes of catheter ablation for AF performed at a facility with and without CTS.

Methods: This was a retrospective study of consecutive patients who underwent catheter ablation for AF at hospital with (CTS) and without cardiothoracic surgery (N-CTS) from January 2011 through December 2019. Clinical and procedural characteristics, complications, and 1-year outcomes, including clinical events and AF recurrence, were collected.

Results: There were 326 unique patients who underwent an index AF ablation procedure: 206 CTS patients and 120 N-CTS patients. There were no differences in overall cardiac complications (2.5% vs. 5.8%), including mapping catheter entrapment requiring open-heart surgery (0% vs. 0.5%), pericardial effusion requiring pericardiocentesis (0.8% vs. 0.5%), hemopericardium (1.7% vs. 0.5%), acute myocardial infarction (0% vs. 1.0%), and sinus node injury (0% versus 0.5%) (all P values > .05) between N-CTS and CTS patients. Likewise, overall noncardiac complications (20.7% vs. 19.8%, P = .85), including bleeding, cerebrovascular accident, and phrenic or vagus nerve injury, were similar between N-CTS and CTS hospitals. Also, 1-year cumulative Kaplan-Meier estimates of overall AF recurrence (11.6% vs. 16.4%; log-rank P = 0.21; HR 1.47; 95% CI, 0.79-2.74) were not statistically significant between N-CTS and CTS hospitals.

Conclusion: Catheter ablation procedure is safe and effective regardless of onsite CTS presence, and there were no significant differences between the two hospital settings.

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在有和没有现场心胸外科的社区医院进行心房颤动消融术的结果。

背景：关于心房颤动（房颤）导管消融术效果的数据有限，这取决于医院的环境，特别是是否有现场心胸外科（CTS）。我们旨在描述在有 CTS 和没有 CTS 的医院进行房颤导管消融的特点和结果：这是一项回顾性研究，研究对象是 2011 年 1 月至 2019 年 12 月期间在有心胸手术（CTS）和无心胸手术（N-CTS）的医院接受房颤导管消融术的连续患者。收集了患者的临床和手术特征、并发症以及一年后的结果，包括临床事件和房颤复发：共有 326 名患者接受了房颤消融术：206名CTS患者和120名N-CTS患者。N-CTS 和 CTS 患者的总体心脏并发症（2.5% 对 5.8%）没有差异，包括需要开胸手术的映射导管夹层（0% 对 0.5%）、需要心包穿刺的心包积液（0.8% 对 0.5%）、血心包积液（1.7% 对 0.5%）、急性心肌梗死（0% 对 1.0%）和窦房结损伤（0% 对 0.5%）（所有 P 值均大于 0.05）。同样，包括出血、脑血管意外、膈神经或迷走神经损伤在内的整体非心脏并发症（20.7% 对 19.8%，P = .85）在 N-CTS 和 CTS 医院之间也相似。此外，N-CTS医院和CTS医院间房颤复发率的1年累积Kaplan-Meier估计值（11.6% vs. 16.4%；log-rank P = 0.21；HR 1.47；95% CI，0.79-2.74）也无统计学意义：结论：无论现场是否存在 CTS，导管消融术都是安全有效的，两家医院之间没有显著差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.