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Temporal changes in patient characteristics and prior pharmacotherapy in patients undergoing radiofrequency ablation of atrial fibrillation: a Danish nationwide cohort study.
MedLine Citation:
PMID:  23284140     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Trends in patient selection and pharmacotherapy before radiofrequency ablation (RFA) of atrial fibrillation are not well studied. We examined temporal trends in RFA utilization on a nationwide scale in Denmark.METHODS AND RESULTS: Using the cross-linkage of nationwide registers, 3302 atrial fibrillation patients treated with 'first-ever' RFA between 2000 and 2009 were identified. Median age was 59 years (interquartile range 53-65) and 73.8% were males. From 2000-01 to 2008-09 the median age increased from 55 (48-61) to 61 (55-66) years (P < 0.0001). The proportion of patients with hypertension and diabetes mellitus increased from 34.8 to 50.6% (P < 0.0001) and 2.2 to 5.9% (P < 0.01), respectively. The proportion of patients with heart failure, vascular disease or previous stroke remained unchanged. The percentage of patients with CHA(2)DS(2)-VASc score ≥2 increased from 23.9 to 41.5% (P < 0.0001). The proportion of patients who did not receive any class Ic or class III antiarrhythmic drugs (AADs) within 2 years prior to 'first-ever' RFA increased from 8.7 to 22.7% (P < 0.0001). Prior use of sotalol and class Ic AADs decreased from 63 to 6.3% (P < 0.0001) and from 35 to 24% (P < 0.0001), respectively. Amiodarone and beta-blockers prior to RFA were used in 36 and 82% of all patients, respectively, without significant temporal changes.CONCLUSION: During a 10-year period, RFA was increasingly performed in older patients with higher co-morbidity, and without prior trial of antiarrhythmic therapy. These findings may provide a framework to understand the outcomes of RFA.
Authors:
Deniz Karasoy; Gunnar Hilmar Gislason; Jim Hansen; Jonas Bjerring Olesen; Christian Torp-Pedersen; Arne Johannessen; Morten Lock Hansen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-2
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology-post 635, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
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