Readmissions and repeat procedures after catheter ablation for atrial fibrillation
Readmissions and repeat procedures after catheter ablation for atrial fibrillation
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DOI：
10.5603/cj.a2015.0037
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发表时间：
2015-11-01
影响因子：
2.9
通讯作者：
Kazmierczak, Jaroslaw
中科院分区：
文献类型：
--
作者：
Opolski, Grzegorz;Januszkiewicz, Lukasz;Kazmierczak, Jaroslaw
背景资料：本研究的目的是评估房颤/房扑（AF/AFl）患者的全因再住院率、房颤/房扑重复消融率、房颤/房扑消融术后30天内死亡率和1年随访率。使用国家卫生基金的数据，我们确定了一个数据库，其中包括2,022名在1月至12月期间接受AF/AFI消融术的患者，2012年和2012年12月在波兰。主要终点是出院诊断为AF/AF I的再次入院。次要终点包括：重复AF/AF I消融、心血管住院、全因住院、30天和1年时间范围内评估的全因死亡率。结果：平均年龄为58.6 ± 10.9岁（66.8%男性）。首次消融术的平均住院时间为3.8 ± 2.6天。出院后，分别有123例（6.1%）和540例（26.7%）患者在30天和1年内因AF/AF I住院。在1年随访期间，192例（9.5%）患者接受了后续AF/AFI消融。接受第二次消融的患者更年轻（56.6 ± 11.0 vs. 59.1 ± 10.8; p = 0.019），首次住院时间更短（3.75 ± 2.16 vs. 4.45 ± 3.26; p = 0.03）。30天内，194例（9.6%）患者住院，747例（36.9%）患者接受1年随访。30天和1年随访时全因死亡率分别为0.1%和1.4%。在1年的随访中，因AF/AF I复发而住院的患者更常因AF/AF I以外的心血管疾病而住院（9.6% vs. 6.7%; p = 0.026），尤其是由于高血压结论：4例房颤/房扑消融术患者中有1例以上患者在1年内因心律失常复发而住院。
Background: The aim of this study was to assess the frequency of all-cause rehospitalization and due to atrial fibrillation/flutter (AF/AFl), repeat ablation of AF/AFl, mortality within 30 days and 1-year follow-up in patients after AF/AFl ablation procedure.Methods: Using data from the National Health Fund we identified a database comprising 2,022 patients who underwent AF/AFl ablation between January, 2012 and December, 2012 in Poland. The primary endpoint was readmission to hospital with discharge diagnosis AF/AFl. The secondary endpoints included: repeat AF/AFl ablation, cardiovascular hospitalization, all-cause hospitalization, all-cause mortality assessed in 30-day and 1-year time frame.Results: The mean age was 58.6 +/- 10.9 years (66.8% male). The mean time of the index ablation hospitalization was 3.8 +/- 2.6 days. After discharge, 123 (6.1%) and 540 (26.7%) patients were hospitalized because of AF/AFl within 30 days and 1 year, respectively. During 1-year follow-up, 192 (9.5%) patients underwent subsequent AF/AFl ablations. The patients that underwent the second ablation were younger (56.6 +/- 11.0 vs. 59.1 +/- 10.8; p = 0.019) and the time of the index hospitalization was shorter (3.75 +/- 2.16 vs. 4.45 +/- 3.26; p = 0.03). Within 30 days 194 (9.6%) patients were hospitalized and 747 (36.9%) in 1-year follow-up. All-cause mortality was 0.1% and 1.4% in 30-day and 1-year follow-up, respectively. In a 1-year follow-up patients hospitalized from AF/AFl recurrence were more frequently hospitalized due to cardiovascular diseases other than AF/AFl (9.6% vs. 6.7%; p = 0.026), especially due to hypertension (2.9% vs. 0.7%; p < 0.001).Conclusions: Over 1 out of 4 patients who underwent AF/AFl ablation were hospitalized due to arrhythmia recurrence in 1 year.