Trends in catheter ablation for atrial fibrillation in the United States.
Trends in catheter ablation for atrial fibrillation in the United States.
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DOI：
10.1002/jhm.445
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发表时间：
2009-09-01
影响因子：
2.6
通讯作者：
Fang, Margaret C
中科院分区：
文献类型：
--
作者：
Kneeland, Patrick P;Fang, Margaret C
背景：在美国，导管消融治疗房颤（AF）的数据很少。我们分析了来自全国医院出院调查（NHDS）的数据，以检查15年期间房颤住院患者导管消融率的趋势。目的：研究AF患者的导管消融率。设计：从1990年到2005年，所有在NHDS中使用国际疾病分类第九次修订临床修改（ICD-9-CM）代码的房颤成年患者被识别并评估其是否存在心导管消融程序代码。确定与消融相关的临床特征，并使用多变量logistic回归来确定消融治疗率随时间的变化趋势。结果：我们确定了269,471例房颤患者。房颤患者的导管消融率从1990年的0.06%上升到2005年的0.79%（趋势P < 0.001）。与未接受消融术的患者相比，消融患者更年轻（平均年龄66岁对76岁，P < 0.001），更有可能是男性（57%对43%，P < 0.001），有私人保险（22%对11%，P < 0.001），并且没有以下中风危险因素：充血性心力衰竭，高血压，年龄bb0 - 75岁，糖尿病，或中风/短暂性脑缺血发作（37%对16%，P < 0.001）。在这段时间内，房颤患者的导管消融每年增加15%(95%可信区间[CI]， 13%-16%)，并且在所有年龄组中，包括bb0或=80岁的患者（1990年为0.0%，2005年为0.26%；趋势P < 0.001）。结论：房颤患者的导管消融率随着时间的推移而显著增加，即使在老年患者中也是如此。医学。
BACKGROUND: There are few data on the use of catheter ablation for atrial fibrillation (AF) in the United States. We analyzed data from the National Hospital Discharge Survey (NHDS) to examine trends in the rate of catheter ablation for hospitalized patients with AF over a 15-year period.OBJECTIVE: To examine rates of catheter ablation in patients with AF over time.DESIGN: All adult patients in the NHDS with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for AF from the years 1990 to 2005 were identified and assessed for the presence of a cardiac catheter ablation procedure code. Clinical characteristics associated with ablation were identified and multivariable logistic regression used to determine trends in the rate of ablation therapy over time.RESULTS: We identified 269,471 adults with AF. The rate of catheter ablation in AF patients increased from 0.06% in 1990 to 0.79% in 2005 (P < 0.001 for trend). Compared to those not undergoing ablation, ablated patients were younger (mean age 66 versus 76 years; P < 0.001), more likely to be male (57% versus 43%; P < 0.001), have private insurance (22% versus 11%; P < 0.001), and have a none of the following stroke risk factors: congestive heart failure, hypertension, age >75 years, diabetes mellitus, or stroke/transient ischemic attack (37% versus 16%; P < 0.001). Catheter ablation in AF patients increased by 15% per year over the time period (95% confidence interval [CI], 13%-16%) and across all age groups, including in patients age > or =80 years (0.0% in 1990 and 0.26% in 2005; P < 0.001 for trend).CONCLUSIONS: The rate of catheter ablation in patients with AF is increasing significantly over time, even in the oldest patients. Medicine.