Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology
Objectives Contact force-sensing catheters allow real-time catheter-tissue contact force monitoring during atrial fibrillation. These catheters were rapidly adopted into clinical practice following market introduction in 2014, but concerns have been raised regarding collateral damage such as esophag...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Surgery, Interventions, & Health Technologies |
| Online Access: | https://sit.bmj.com/content/2/1/e000058.full |
| _version_ | 1797215225512984576 |
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| author | Nilay D Shah Xiaoxi Yao Jun Dong Rebecca Ward Joseph G Akar James P Hummel Lindsey Sangaralingham Peter A Noseworthy |
| author_facet | Nilay D Shah Xiaoxi Yao Jun Dong Rebecca Ward Joseph G Akar James P Hummel Lindsey Sangaralingham Peter A Noseworthy |
| author_sort | Nilay D Shah |
| collection | DOAJ |
| description | Objectives Contact force-sensing catheters allow real-time catheter-tissue contact force monitoring during atrial fibrillation. These catheters were rapidly adopted into clinical practice following market introduction in 2014, but concerns have been raised regarding collateral damage such as esophageal injury. We sought to examine whether the introduction of force-sensing catheters was associated with a change in short-term and intermediate-term acute care use, complications and mortality following atrial fibrillation ablation.Design Retrospective cohort analysis. We used inverse probability treatment weight matching to account for the differences in baseline characteristics between groups.Setting We examined patients included in the OptumLabs Data Warehouse who underwent ablation for atrial fibrillation before (2011–2013) and after (2015–2017) the market introduction of contact force-sensing catheters.Main outcome measures We examined 30-day and 90-day rates of all-cause acute care use, including hospitalizations and emergency department visits, as well as death and hospitalization for catheter-related complications, including atrioesophageal fistula, pericarditis, cardiac tamponade/perforation and stroke/transient ischemic attack.Results Our sample included 3470 and 5772 patients who underwent atrial fibrillation (AF) ablation before and after market introduction of contact force-sensing catheters, respectively. Complication rates were low and did not differ between the two periods (p>0.10 for each outcome). The 30-day and 90-day mortality was 0.1% and 0.3%, respectively after market introduction and unchanged from prior to 2014. The 90-day rates of all-cause acute care use decreased, from 27.0% in 2011–2013 to 23.9% in 2015–2017 (p<0.001).Conclusions AF ablation-related catheter complications and mortality are low and there has been no significant change following the introduction of force-sensing catheters. |
| first_indexed | 2024-04-24T11:26:41Z |
| format | Article |
| id | doaj.art-5d96ee6ddc82497cb489ec4c44c8d15c |
| institution | Directory Open Access Journal |
| issn | 2631-4940 |
| language | English |
| last_indexed | 2024-04-24T11:26:41Z |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Surgery, Interventions, & Health Technologies |
| spelling | doaj.art-5d96ee6ddc82497cb489ec4c44c8d15c2024-04-10T16:40:08ZengBMJ Publishing GroupBMJ Surgery, Interventions, & Health Technologies2631-49402020-10-012110.1136/bmjsit-2020-000058Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technologyNilay D Shah0Xiaoxi Yao1Jun Dong2Rebecca Ward3Joseph G Akar4James P Hummel5Lindsey Sangaralingham6Peter A Noseworthy7Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo ClinicDivision of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USADepartment of Neurology, Army Medical Center of PLA, Army Medical University, Chongqing, ChinaCenter for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USASection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USASection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USARobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USACardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USAObjectives Contact force-sensing catheters allow real-time catheter-tissue contact force monitoring during atrial fibrillation. These catheters were rapidly adopted into clinical practice following market introduction in 2014, but concerns have been raised regarding collateral damage such as esophageal injury. We sought to examine whether the introduction of force-sensing catheters was associated with a change in short-term and intermediate-term acute care use, complications and mortality following atrial fibrillation ablation.Design Retrospective cohort analysis. We used inverse probability treatment weight matching to account for the differences in baseline characteristics between groups.Setting We examined patients included in the OptumLabs Data Warehouse who underwent ablation for atrial fibrillation before (2011–2013) and after (2015–2017) the market introduction of contact force-sensing catheters.Main outcome measures We examined 30-day and 90-day rates of all-cause acute care use, including hospitalizations and emergency department visits, as well as death and hospitalization for catheter-related complications, including atrioesophageal fistula, pericarditis, cardiac tamponade/perforation and stroke/transient ischemic attack.Results Our sample included 3470 and 5772 patients who underwent atrial fibrillation (AF) ablation before and after market introduction of contact force-sensing catheters, respectively. Complication rates were low and did not differ between the two periods (p>0.10 for each outcome). The 30-day and 90-day mortality was 0.1% and 0.3%, respectively after market introduction and unchanged from prior to 2014. The 90-day rates of all-cause acute care use decreased, from 27.0% in 2011–2013 to 23.9% in 2015–2017 (p<0.001).Conclusions AF ablation-related catheter complications and mortality are low and there has been no significant change following the introduction of force-sensing catheters.https://sit.bmj.com/content/2/1/e000058.full |
| spellingShingle | Nilay D Shah Xiaoxi Yao Jun Dong Rebecca Ward Joseph G Akar James P Hummel Lindsey Sangaralingham Peter A Noseworthy Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology BMJ Surgery, Interventions, & Health Technologies |
| title | Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology |
| title_full | Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology |
| title_fullStr | Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology |
| title_full_unstemmed | Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology |
| title_short | Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology |
| title_sort | catheter related complications and mortality of atrial fibrillation ablation following introduction of contact force sensing technology |
| url | https://sit.bmj.com/content/2/1/e000058.full |
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