Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation
Abstract Background Ablation strategies and modalities for atrial fibrillation (AF) have transitioned over the past decade, but their impact on post‐ablation medication and clinical outcomes remains to be fully investigated. Methods We divided 682 patients who had undergone AF ablation in 2014–2019...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12854 |
| _version_ | 1797804566529441792 |
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| author | Moyuru Hirata Koichi Nagashima Ryuta Watanabe Yuji Wakamatsu Naoto Otsuka Satoshi Hayashida Shu Hirata Masanaru Sawada Sayaka Kurokawa Yasuo Okumura |
| author_facet | Moyuru Hirata Koichi Nagashima Ryuta Watanabe Yuji Wakamatsu Naoto Otsuka Satoshi Hayashida Shu Hirata Masanaru Sawada Sayaka Kurokawa Yasuo Okumura |
| author_sort | Moyuru Hirata |
| collection | DOAJ |
| description | Abstract Background Ablation strategies and modalities for atrial fibrillation (AF) have transitioned over the past decade, but their impact on post‐ablation medication and clinical outcomes remains to be fully investigated. Methods We divided 682 patients who had undergone AF ablation in 2014–2019 (420 paroxysmal AFs [PAF], 262 persistent AFs [PerAF]) into three groups according to the period, that is, the 2014–2015 (n = 139), 2016–2017 (n = 244), and 2018–2019 groups (n = 299), respectively. Results Persistent AF became more prevalent and the left atrial (LA) diameter larger over the 6 years. Extra‐pulmonary vein (PV)‐LA ablation was more frequently performed in the 2014–2015 group than in the 2016–2017 and 2018–2019 groups (41.1% vs. 9.1% and 8.1%; p < .001). The 2‐year freedom rate from AF/atrial tachycardias for PAF was similar among the three groups (84.0% vs. 83.1% vs. 86.7%; p = .98) but lowest in the 2014–2015 group for PerAF (63.9% vs. 82.7% and 86.3%; p = .025) despite the highest post‐ablation antiarrhythmic drug use. Cardiac tamponade was significantly decreased in the 2018–2019 group (3.6% vs. 2.0% vs. 0.33%; p = 0.021). There was no difference in the 2‐year clinically relevant events among the three groups. Conclusion Although ablation was performed in a more diseased LA and extra‐PV‐LA ablation was less frequent in recent years, the complication rate decreased, and AF recurrences for PAF remained unchanged, but that for PerAF decreased. Clinically relevant events remained unchanged over the recent 6 years, suggesting that the impact of the recent ablation modalities and strategies on remote clinically relevant events may be small during this study period. |
| first_indexed | 2024-03-13T05:38:07Z |
| format | Article |
| id | doaj.art-f0a8c673ee4b4df2b258004629164b35 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-13T05:38:07Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-f0a8c673ee4b4df2b258004629164b352023-06-14T05:25:21ZengWileyJournal of Arrhythmia1880-42761883-21482023-06-0139336637510.1002/joa3.12854Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablationMoyuru Hirata0Koichi Nagashima1Ryuta Watanabe2Yuji Wakamatsu3Naoto Otsuka4Satoshi Hayashida5Shu Hirata6Masanaru Sawada7Sayaka Kurokawa8Yasuo Okumura9Division of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanDivision of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo JapanAbstract Background Ablation strategies and modalities for atrial fibrillation (AF) have transitioned over the past decade, but their impact on post‐ablation medication and clinical outcomes remains to be fully investigated. Methods We divided 682 patients who had undergone AF ablation in 2014–2019 (420 paroxysmal AFs [PAF], 262 persistent AFs [PerAF]) into three groups according to the period, that is, the 2014–2015 (n = 139), 2016–2017 (n = 244), and 2018–2019 groups (n = 299), respectively. Results Persistent AF became more prevalent and the left atrial (LA) diameter larger over the 6 years. Extra‐pulmonary vein (PV)‐LA ablation was more frequently performed in the 2014–2015 group than in the 2016–2017 and 2018–2019 groups (41.1% vs. 9.1% and 8.1%; p < .001). The 2‐year freedom rate from AF/atrial tachycardias for PAF was similar among the three groups (84.0% vs. 83.1% vs. 86.7%; p = .98) but lowest in the 2014–2015 group for PerAF (63.9% vs. 82.7% and 86.3%; p = .025) despite the highest post‐ablation antiarrhythmic drug use. Cardiac tamponade was significantly decreased in the 2018–2019 group (3.6% vs. 2.0% vs. 0.33%; p = 0.021). There was no difference in the 2‐year clinically relevant events among the three groups. Conclusion Although ablation was performed in a more diseased LA and extra‐PV‐LA ablation was less frequent in recent years, the complication rate decreased, and AF recurrences for PAF remained unchanged, but that for PerAF decreased. Clinically relevant events remained unchanged over the recent 6 years, suggesting that the impact of the recent ablation modalities and strategies on remote clinically relevant events may be small during this study period.https://doi.org/10.1002/joa3.12854atrial fibrillationcatheter ablationclinical outcome |
| spellingShingle | Moyuru Hirata Koichi Nagashima Ryuta Watanabe Yuji Wakamatsu Naoto Otsuka Satoshi Hayashida Shu Hirata Masanaru Sawada Sayaka Kurokawa Yasuo Okumura Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation Journal of Arrhythmia atrial fibrillation catheter ablation clinical outcome |
| title | Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation |
| title_full | Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation |
| title_fullStr | Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation |
| title_full_unstemmed | Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation |
| title_short | Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation |
| title_sort | trends over the recent 6 years in ablation modalities and strategies post ablation medication and clinical outcomes of atrial fibrillation ablation |
| topic | atrial fibrillation catheter ablation clinical outcome |
| url | https://doi.org/10.1002/joa3.12854 |
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