PMID- 29759674
OWN - NLM
STAT- MEDLINE
DCOM- 20190722
LR  - 20190722
IS  - 2405-5018 (Electronic)
IS  - 2405-500X (Linking)
VI  - 3
IP  - 12
DP  - 2017 Dec 11
TI  - Population-Based Evaluation of Major Adverse Events After Catheter Ablation for 
      Atrial Fibrillation.
PG  - 1425-1433
LID - S2405-500X(17)30390-0 [pii]
LID - 10.1016/j.jacep.2017.04.010 [doi]
AB  - OBJECTIVES: The purpose of this study was to evaluate the safety and incidence of 
      periprocedural adverse events (AEs) among patients who underwent catheter 
      ablation (CA) for atrial fibrillation (AF) in Quebec and Ontario, Canada. 
      BACKGROUND: CA is evolving into the mainstay therapy for patients with 
      symptomatic AF refractory to antiarrhythmic medication. However, the safety of CA 
      at the population level over time requires further evaluation. METHODS: A 
      population-based cohort was constructed using administrative databases of all 
      patients who underwent CA between 1999 and 2014 in Quebec and Ontario, Canada. 
      Incidence and predictors of AEs were assessed within 30 days of CA. Major AEs 
      included all-cause mortality, cerebrovascular accident (CVA) including transient 
      ischemic attack, pericardial effusion requiring drainage (PERD), vascular AEs, 
      hemorrhage/hematoma, and pulmonary embolism. RESULTS: Of 6,388 patients who had a 
      CA (mean age 57.3 years; mean CHA(2)DS(2)-VASc 1.1 +/- 1.4; 27.6% female), 
      221 (3.5%) patients developed major AEs within 30 days of index CA. 
      Hemorrhage/hematoma was the most frequent (1.4%), followed by PERD (1.0%) and CVA 
      (0.6%). PERD was more likely to occur post-discharge than during the index CA 
      (p < 0.05). CVA decreased by more than 50% in patients with recent compared with 
      remote CA (p < 0.05). Compared with index CA, the incidence of PERD and 
      hemorrhage/hematoma was greater at first repeat CA (p < 0.05 for both). 
      CONCLUSIONS: CA is a relatively safe procedure with low incidence of major AEs. 
      The incidence of procedure-related CVA appeared to decline significantly over 
      time. Incidence of PERD remained relatively stable and was more likely to 
      be diagnosed after discharge and following repeat CA.
CI  - Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Samuel, Michelle
AU  - Samuel M
AD  - Division of Clinical Epidemiology, McGill University Health Centre Research 
      Institute, Montreal, Quebec, Canada.
FAU - Almohammadi, Mohammad
AU  - Almohammadi M
AD  - Division of General Internal Medicine, McGill University Health Centre Research 
      Institute, Montreal, Quebec, Canada.
FAU - Tsadok, Meytal Avgil
AU  - Tsadok MA
AD  - Division of Clinical Epidemiology, McGill University Health Centre Research 
      Institute, Montreal, Quebec, Canada.
FAU - Joza, Jacqueline
AU  - Joza J
AD  - Division of Cardiology, McGill University Health Centre Research Institute, 
      Montreal, Quebec, Canada.
FAU - Jackevicius, Cynthia A
AU  - Jackevicius CA
AD  - Institute of Clinical Evaluative Sciences, University Health Network, University 
      of Toronto, Toronto, Ontario, Canada; Veterans Administration Greater Los Angeles 
      Health System, Western University of Health Sciences, Los Angeles, California.
FAU - Koh, Maria
AU  - Koh M
AD  - Institute of Clinical Evaluative Sciences, University Health Network, University 
      of Toronto, Toronto, Ontario, Canada.
FAU - Behlouli, Hassan
AU  - Behlouli H
AD  - Division of Clinical Epidemiology, McGill University Health Centre Research 
      Institute, Montreal, Quebec, Canada.
FAU - Verma, Atul
AU  - Verma A
AD  - Division of Cardiology, McGill University Health Centre Research Institute, 
      Montreal, Quebec, Canada.
FAU - Pilote, Louise
AU  - Pilote L
AD  - Division of Clinical Epidemiology, McGill University Health Centre Research 
      Institute, Montreal, Quebec, Canada; Division of General Internal Medicine, 
      McGill University Health Centre Research Institute, Montreal, Quebec, Canada. 
      Electronic address: louise.pilote@mcgill.ca.
FAU - Essebag, Vidal
AU  - Essebag V
AD  - Division of Cardiology, McGill University Health Centre Research Institute, 
      Montreal, Quebec, Canada.
LA  - eng
GR  - CIHR/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170830
PL  - United States
TA  - JACC Clin Electrophysiol
JT  - JACC. Clinical electrophysiology
JID - 101656995
SB  - IM
CIN - JACC Clin Electrophysiol. 2017 Dec 11;3(12):1434-1436. PMID: 29759675
MH  - Aged
MH  - Atrial Fibrillation/*therapy
MH  - Canada/epidemiology
MH  - Catheter Ablation/*adverse effects/methods
MH  - Drainage/methods
MH  - Female
MH  - Hematoma/epidemiology/etiology
MH  - Hemorrhage/epidemiology/etiology
MH  - Humans
MH  - Incidence
MH  - Ischemic Attack, Transient
MH  - Male
MH  - Middle Aged
MH  - Ontario
MH  - Pericardial Effusion/*epidemiology/etiology/therapy
MH  - Perioperative Care/adverse effects/*mortality
MH  - Pulmonary Embolism/epidemiology/etiology
MH  - Quebec
MH  - Stroke/epidemiology/etiology
OTO - NOTNLM
OT  - cardiac tamponade
OT  - cerebrovascular accident
OT  - pericardial effusion
OT  - pulmonary vein isolation
EDAT- 2018/05/16 06:00
MHDA- 2019/07/23 06:00
CRDT- 2018/05/16 06:00
PHST- 2016/12/19 00:00 [received]
PHST- 2017/04/05 00:00 [revised]
PHST- 2017/04/11 00:00 [accepted]
PHST- 2018/05/16 06:00 [entrez]
PHST- 2018/05/16 06:00 [pubmed]
PHST- 2019/07/23 06:00 [medline]
AID - S2405-500X(17)30390-0 [pii]
AID - 10.1016/j.jacep.2017.04.010 [doi]
PST - ppublish
SO  - JACC Clin Electrophysiol. 2017 Dec 11;3(12):1425-1433. doi: 
      10.1016/j.jacep.2017.04.010. Epub 2017 Aug 30.