دورية أكاديمية
أعرض في EDS

Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy.

التفاصيل البيبلوغرافية
العنوان: Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy.
المؤلفون: Bassiouny M; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Lindsay BD; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Lever H; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Saliba W; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Klein A; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Banna M; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Abraham J; Minneapolis Heart Institute, Minneapolis, Minnesota., Shao M; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Rickard J; Johns Hopkins, Baltimore, Maryland., Kanj M; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Tchou P; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Dresing T; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Baranowski B; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Bhargava M; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Callahan T; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Tarakji K; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Cantillon D; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Hussein A; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Marc Gillinov A; Department of Cardiothoracic Surgery, Cleveland Clinic, Cleveland, Ohio., Smedira NG; Department of Cardiothoracic Surgery, Cleveland Clinic, Cleveland, Ohio., Wazni O; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. Electronic address: waznio@ccf.org.
المصدر: Heart rhythm [Heart Rhythm] 2015 Jul; Vol. 12 (7), pp. 1438-47. Date of Electronic Publication: 2015 Mar 23.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier, c2004-
مواضيع طبية MeSH: Atrial Fibrillation*/diagnosis , Atrial Fibrillation*/etiology , Atrial Fibrillation*/physiopathology , Atrial Fibrillation*/surgery , Catheter Ablation*/adverse effects , Catheter Ablation*/methods , Postoperative Complications*/diagnosis , Postoperative Complications*/surgery , Reoperation*/methods , Reoperation*/statistics & numerical data, Cardiomyopathy, Hypertrophic/*complications, Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Prognosis ; Pulmonary Veins/surgery ; Recurrence ; Risk Factors ; Stroke Volume ; United States
مستخلص: Background: Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM).
Objective: The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM.
Methods: One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58% ± 8%) with symptomatic paroxysmal (58%), persistent (31%), and long-standing persistent AF (11%) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included.
Results: After follow-up of 35 months (interquartile range 13, 60), 29% of patients who underwent catheter ablation and 51% of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55% of patients with recurrent arrhythmia in the catheter group and 24% in the surgery group, increasing the success rate to 39% and 53%, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6% of the catheter ablation group and 18% of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death.
Conclusion: Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.
(Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Atrial fibrillation; Catheter ablation; Hypertrophic cardiomyopathy; Maze procedure; Pulmonary vein isolation; Surgery
تواريخ الأحداث: Date Created: 20150328 Date Completed: 20160427 Latest Revision: 20191210
رمز التحديث: 20240628
DOI: 10.1016/j.hrthm.2015.03.042
PMID: 25814420
قاعدة البيانات: MEDLINE
الوصف
تدمد:1556-3871
DOI:10.1016/j.hrthm.2015.03.042