A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes

被引：85

作者：

Holmqvist, Fredrik ^{[1
]}

Kesek, Milos ^{[2
]}

Englund, Anders ^{[3
]}

Blomstrom-Lundqvist, Carina ^{[4
]}

Karlsson, Lars O. ^{[5
]}

Kenneback, Goran ^{[6
]}

Poci, Dritan ^{[7
]}

Samo-Ayou, Romeo ^{[8
]}

Sigurjonsdottir, Runa ^{[9
]}

Ringborn, Michael ^{[10
]}

Herczku, Csaba ^{[11
]}

Carlson, Jonas ^{[1
]}

Fengsrud, Espen ^{[7
]}

Tabrizi, Fariborz ^{[3
]}

Hoglund, Niklas ^{[2
]}

Lonnerholm, Stefan ^{[4
]}

Kongstad, Ole ^{[1
]}

Jonsson, Anders ^{[5
]}

Insulander, Per ^{[6
]}

机构：

[1] Lund Univ, Skane Univ Hosp, Dept Cardiol, SE-22185 Lund, Sweden

[2] Umea Univ Hosp, Dept Cardiol, SE-90189 Umea, Sweden

[3] Karolinska Inst, Dept Clin Sci, Arrhythmia Ctr, South Hosp, SE-11861 Stockholm, Sweden

[4] Uppsala Univ Hosp, Dept Cardiol, SE-75185 Uppsala, Sweden

[5] Linkoping Univ Hosp, Dept Cardiol, SE-58185 Linkoping, Sweden

[6] Karolinska Univ Hosp, Dept Cardiol, SE-17176 Solna, Sweden

[7] Univ Hosp Orebro, Dept Cardiol, SE-70185 Orebro, Sweden

[8] Skaraborg Hosp, Dept Cardiol, SE-54142 Skovde, Sweden

[9] Sahlgrens Univ Hosp, Dept Cardiol, SE-41345 Gothenburg, Sweden

[10] Blekinge Cty Hosp, Thorac Ctr, S-37185 Karlskrona, Sweden

[11] Norra Alvsborg Cty Hosp, Dept Cardiol, SE-46173 Trollhattan, Sweden

来源：

EUROPEAN HEART JOURNAL | 2019年 / 40卷 / 10期

关键词：

Catheter ablation; Adverse events; Outcome; ATRIAL-FIBRILLATION; RADIOFREQUENCY ABLATION; EUROPEAN-SOCIETY; ESC GUIDELINES; TACHYCARDIA; MANAGEMENT; SYSTEM; DEATH;

D O I：

10.1093/eurheartj/ehy709

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. Methods and Results Consecutive patients (18years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26642 patients (5715years, 62% men), undergoing a total of 34428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P<0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3years). The rate of reported adverse events was low (n=595, 1.7%). Death in the immediate period following ablation was rare (n=116, 0.34%). Conclusion Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.

引用

页码：820 / 830

页数：11

共 24 条

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