Impact of catheter ablation in patients with atrial flutter and concurrent heart failure
Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF). Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF. Methods: This retrospective cohort study identifi...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | Heart Rhythm O2 |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501820301495 |
| _version_ | 1818964187087372288 |
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| author | Chinmay Jani, MD Shilpkumar Arora, MD, MPH Zachary Zuzek, MD Rahul Jaswaney, MD Samarthkumar Thakkar, MD Harsh P. Patel, MD Sopan Lahewala, MD Nirav Arora, MS Richard Josephson, MD Abhishek Deshmukh, MD Juan Viles-Gonzalez, MD Mohammed Najeeb Osman, MD, FHRS Jayakumar Sahadevan, MD Brian D. Hoit, MD Judith A. Mackall, MD, FHRS |
| author_facet | Chinmay Jani, MD Shilpkumar Arora, MD, MPH Zachary Zuzek, MD Rahul Jaswaney, MD Samarthkumar Thakkar, MD Harsh P. Patel, MD Sopan Lahewala, MD Nirav Arora, MS Richard Josephson, MD Abhishek Deshmukh, MD Juan Viles-Gonzalez, MD Mohammed Najeeb Osman, MD, FHRS Jayakumar Sahadevan, MD Brian D. Hoit, MD Judith A. Mackall, MD, FHRS |
| author_sort | Chinmay Jani, MD |
| collection | DOAJ |
| description | Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF). Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF. Methods: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016–17 Nationwide Readmissions Database. The primary outcome was a composite of all-cause mortality and/or HF readmission at 1 year. Secondary outcomes included HF readmission, all-cause mortality, and atrial fibrillation (AF) readmission at 1 year. Propensity score match (1:2) algorithm was used to adjust for confounders. Cox proportional hazard regression was used to generate hazard ratios. Results: Of the 15,952 patients, 9889 had heart failure with reduced ejection fraction (HFrEF) and 6063 had heart failure with preserved ejection fraction (HFpEF). In the matched HFrEF cohort (n = 5421), the primary outcome was significantly lower in patients undergoing ablation (HR 0.72, 95% CI 0.61–0.85, P < .001). HF readmission (HR 0.73, 95% CI 0.61–0.89, P = .001), all-cause mortality (HR 0.62, 95% CI 0.46–0.85, P = .003), and AF readmission (HR 0.63, 95% CI 0.48–0.82, P = .001) were also significantly reduced. In the matched HFpEF cohort (n = 2439), the primary outcome was lower in the group receiving ablation but was not statistically significant (HR 0.80, 95% CI 0.63–1.01, P = .065). Conclusion: In patients with AFL and HFrEF, AFL ablation was associated with lower mortality and HF readmissions at 1 year. Patients with AFL and HFpEF did not show a similar significant reduction in the primary outcome. |
| first_indexed | 2024-12-20T12:57:07Z |
| format | Article |
| id | doaj.art-1097ad03ed1f4f1bad220e27d9adec44 |
| institution | Directory Open Access Journal |
| issn | 2666-5018 |
| language | English |
| last_indexed | 2024-12-20T12:57:07Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj.art-1097ad03ed1f4f1bad220e27d9adec442022-12-21T19:40:02ZengElsevierHeart Rhythm O22666-50182021-02-01215363Impact of catheter ablation in patients with atrial flutter and concurrent heart failureChinmay Jani, MD0Shilpkumar Arora, MD, MPH1Zachary Zuzek, MD2Rahul Jaswaney, MD3Samarthkumar Thakkar, MD4Harsh P. Patel, MD5Sopan Lahewala, MD6Nirav Arora, MS7Richard Josephson, MD8Abhishek Deshmukh, MD9Juan Viles-Gonzalez, MD10Mohammed Najeeb Osman, MD, FHRS11Jayakumar Sahadevan, MD12Brian D. Hoit, MD13Judith A. Mackall, MD, FHRS14Mount Auburn Hospital-Harvard Medical School, Cambridge, MassachusettsHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioRochester General Hospital, Rochester, New YorkLouis A. Weiss Memorial Hospital, Chicago, IllinoisUniversity of Connecticut, Hartford, ConnecticutLamar University, Beaumont, TexasHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioMayo Clinic, Rochester, MinnesotaMiami Cardiac and Vascular Institute/ Baptist Health South Florida, Miami, FloridaHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OhioHarrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, Ohio; Address reprint requests and correspondence: Dr Judith A. Mackall, Division of Cardiology, Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5038.Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF). Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF. Methods: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016–17 Nationwide Readmissions Database. The primary outcome was a composite of all-cause mortality and/or HF readmission at 1 year. Secondary outcomes included HF readmission, all-cause mortality, and atrial fibrillation (AF) readmission at 1 year. Propensity score match (1:2) algorithm was used to adjust for confounders. Cox proportional hazard regression was used to generate hazard ratios. Results: Of the 15,952 patients, 9889 had heart failure with reduced ejection fraction (HFrEF) and 6063 had heart failure with preserved ejection fraction (HFpEF). In the matched HFrEF cohort (n = 5421), the primary outcome was significantly lower in patients undergoing ablation (HR 0.72, 95% CI 0.61–0.85, P < .001). HF readmission (HR 0.73, 95% CI 0.61–0.89, P = .001), all-cause mortality (HR 0.62, 95% CI 0.46–0.85, P = .003), and AF readmission (HR 0.63, 95% CI 0.48–0.82, P = .001) were also significantly reduced. In the matched HFpEF cohort (n = 2439), the primary outcome was lower in the group receiving ablation but was not statistically significant (HR 0.80, 95% CI 0.63–1.01, P = .065). Conclusion: In patients with AFL and HFrEF, AFL ablation was associated with lower mortality and HF readmissions at 1 year. Patients with AFL and HFpEF did not show a similar significant reduction in the primary outcome.http://www.sciencedirect.com/science/article/pii/S2666501820301495Atrial flutterCatheter ablationHeart failureNationwide Readmissions Database |
| spellingShingle | Chinmay Jani, MD Shilpkumar Arora, MD, MPH Zachary Zuzek, MD Rahul Jaswaney, MD Samarthkumar Thakkar, MD Harsh P. Patel, MD Sopan Lahewala, MD Nirav Arora, MS Richard Josephson, MD Abhishek Deshmukh, MD Juan Viles-Gonzalez, MD Mohammed Najeeb Osman, MD, FHRS Jayakumar Sahadevan, MD Brian D. Hoit, MD Judith A. Mackall, MD, FHRS Impact of catheter ablation in patients with atrial flutter and concurrent heart failure Heart Rhythm O2 Atrial flutter Catheter ablation Heart failure Nationwide Readmissions Database |
| title | Impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| title_full | Impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| title_fullStr | Impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| title_full_unstemmed | Impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| title_short | Impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| title_sort | impact of catheter ablation in patients with atrial flutter and concurrent heart failure |
| topic | Atrial flutter Catheter ablation Heart failure Nationwide Readmissions Database |
| url | http://www.sciencedirect.com/science/article/pii/S2666501820301495 |
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