PMID- 31578788
OWN - NLM
STAT- MEDLINE
DCOM- 20201019
LR  - 20201019
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 30
IP  - 12
DP  - 2019 Dec
TI  - Population-level evaluation of complications after catheter ablation in patients 
      with atrial fibrillation and heart failure.
PG  - 2678-2685
LID - 10.1111/jce.14202 [doi]
AB  - INTRODUCTION: Catheter ablation (CA) has been increasingly used to treat atrial 
      fibrillation (AF) in patients with heart failure (HF), however, its safety at the 
      population-level has not yet been evaluated. To assess the safety of CA in AF-HF 
      patients, the frequency and potential risk factors for adverse events (AEs) 
      within 30 days post-CA were determined. METHODS: A population-based cohort of 
      AF-HF patients who underwent CA in Quebec, Canada (2000-2017) was constructed 
      using administrative databases. Major AEs included all-cause mortality, 
      cerebrovascular accident (CVA), pericardial effusion requiring drainage (PERD), 
      vascular AEs, hemorrhage/hematoma, and pulmonary embolism. Univariate logistic 
      regression models were employed to assess potential risk factors for major AEs. 
      RESULTS: Of 700 AF-HF patients who underwent CA (median age 64.5 years 
      [interquartile range, IQR, 56.2-71.0], 22.0% female, and median CHA(2) DS(2) 
      -Vasc 3 [IQR, 2-4]), 14 (2.0%) patients developed 16 major AEs within 30 days of 
      CA. Hemorrhage/hematoma was the most frequent major AE (four patients; 0.6%) 
      followed by all-cause mortality, CVA/TIA, PERD, and vascular AEs (three patients 
      each; 0.4%). Coronary artery disease (odds ratio [OR], 3.9 [95% confidence 
      interval, CI, 1.2-12.3]) and age >/=65 years (OR, 3.1 [95% CI, 1.1-9.8]) were 
      identified predictors for the composite outcome of major AEs. More than half of 
      the patients (57.2%) underwent a second CA within a median of 0.8 (IQR, 0.2-2.2) 
      years from the date of first CA. CONCLUSION: CA performed in the AF-HF population 
      portends a relatively low incidence of major AEs. A larger study is required to 
      determine whether certain patient factors are independently associated with a 
      higher risk of post-CA AEs.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Samuel, Michelle
AU  - Samuel M
AD  - Center for Outcomes Research and Evaluation, Research Institute of McGill 
      University Health Center, Montreal, Quebec, Canada.
AD  - Department of Epidemiology, Biostatistics, and Occupational Health, McGill 
      University, Montreal, Quebec, Canada.
FAU - Abrahamowicz, Michal
AU  - Abrahamowicz M
AD  - Center for Outcomes Research and Evaluation, Research Institute of McGill 
      University Health Center, Montreal, Quebec, Canada.
AD  - Department of Epidemiology, Biostatistics, and Occupational Health, McGill 
      University, Montreal, Quebec, Canada.
FAU - Joza, Jacqueline
AU  - Joza J
AD  - Division of Cardiology, McGill University Health Center, McGill University, 
      Montreal, Quebec, Canada.
FAU - Pilote, Louise
AU  - Pilote L
AUID- ORCID: 0000-0002-6159-0628
AD  - Center for Outcomes Research and Evaluation, Research Institute of McGill 
      University Health Center, Montreal, Quebec, Canada.
AD  - Division of General Internal Medicine, McGill University Health Center, Montreal, 
      Quebec, Canada.
FAU - Essebag, Vidal
AU  - Essebag V
AD  - Division of Cardiology, McGill University Health Center, McGill University, 
      Montreal, Quebec, Canada.
LA  - eng
GR  - Clinical Research Scholars Award to Vidal Essebag/Fonds de Recherche du Quebec - 
      Sante/International
GR  - Doctoral Training Award to Michelle Samuel/Fonds de Recherche du Quebec - 
      Sante/International
GR  - James McGill Chair to Louise Pilote (Medicine)/McGill University -/International
GR  - James McGill Chair to Michal Abrahamowicz (Biostatistics)/McGill University 
      -/International
GR  - (133717)/CIHR/Canada
GR  - (133717)/CIHR/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191014
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/diagnosis/mortality/physiopathology/*surgery
MH  - Catheter Ablation/*adverse effects/mortality
MH  - Databases, Factual
MH  - Female
MH  - Heart Failure/diagnosis/*epidemiology/mortality/physiopathology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology/mortality
MH  - Quebec/epidemiology
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adverse events
OT  - atrial fibrillation
OT  - catheter ablation
OT  - heart failure
EDAT- 2019/10/04 06:00
MHDA- 2020/10/21 06:00
CRDT- 2019/10/04 06:00
PHST- 2019/08/16 00:00 [received]
PHST- 2019/09/11 00:00 [revised]
PHST- 2019/09/26 00:00 [accepted]
PHST- 2019/10/04 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2019/10/04 06:00 [entrez]
AID - 10.1111/jce.14202 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2019 Dec;30(12):2678-2685. doi: 10.1111/jce.14202. 
      Epub 2019 Oct 14.