Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA.
Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA.
J Interv Card Electrophysiol. 2022 Mar;63(2):295-302. doi: 10.1007/s10840-021-00982-4. Epub 2021 Mar 26.
Catheter ablation (CA) is indicated as definitive therapy for patients with either typical or atypical atrial flutter (TAFlutter and AAFlutter, respectively) which is unresponsive to medical therapy. There is a paucity of data regarding in-hospital outcomes of patients undergoing CA.
Retrospective study using the NIS to identify patients ≥18 years who underwent CA between 2015 and 2017. Individuals were identified using ICD-10-CM/PCS for TAFlutter, AAFlutter, and CA.
A total of 17,390 patients underwent CA for Aflutter (33% AAFlutter and 67% TAFlutter). The TAFlutter group was younger (mean 65.9 years vs. 67.2 years), with less females (30% vs. 43%, p ≤ 0.001 for both) compared to the AAFlutter group. The TAFlutter group had a higher rate of diabetes, tobacco use, obesity, and chronic obstructive pulmonary disease (p ≤ 0.001 for all). The AAFlutter cohort had increased prior strokes and atrial fibrillation (p ≤ 0.001 for both). The mean CHADS-VASc score was found to be 2.3 in AAFlutter compared to 2.1 in TAFlutter (p ≤ 0.001). There were significantly higher proportions of thromboembolic events, transfusions, and longer length of stay in the TAFlutter group (p ≤ 0.001 for all) with the AAFlutter group having significantly higher rates of cardioversion, implantation of cardiac devices, and increased hospital charges (p ≤ 0.001 for all); no significant difference was found in mortality after controlling for comorbidities.
We found higher complication rates in CA for patients with TAFlutter, but no difference in in-hospital all-cause mortality. Variation in CA depending upon the mechanism of AFlutter may underlie these differences, and warrant further study.
导管消融（CA）是对药物治疗无效的典型或非典型房扑（TAFlutter 和 AAFlutter）患者的明确治疗方法。目前关于接受 CA 治疗的患者住院期间结局的数据很少。
使用 NIS 进行回顾性研究，以确定 2015 年至 2017 年间接受 CA 的年龄≥18 岁的患者。使用 ICD-10-CM/PCS 对 TAFlutter、AAFlutter 和 CA 进行个体识别。
共有 17390 例患者因 Aflutter 接受 CA（33%AAFlutter 和 67%TAFlutter）。TAFlutter 组年龄较小（平均 65.9 岁 vs. 67.2 岁），女性比例较低（30% vs. 43%，均≤0.001）。与 AAFlutter 组相比，TAFlutter 组糖尿病、吸烟、肥胖和慢性阻塞性肺疾病的发生率较高（均≤0.001）。AAFlutter 组既往有更多的中风和心房颤动（均≤0.001）。AAFlutter 组的平均 CHADS-VASc 评分为 2.3，而 TAFlutter 组为 2.1（均≤0.001）。TAFlutter 组的血栓栓塞事件、输血和住院时间较长的比例明显较高（均≤0.001），而 AAFlutter 组的电复律、心脏设备植入和住院费用增加的比例明显较高（均≤0.001）；在控制了合并症后，死亡率无显著差异。
我们发现 TAFlutter 患者的 CA 并发症发生率较高，但住院期间全因死亡率无差异。根据 AFlutter 机制的不同，CA 存在差异，这可能是导致这些差异的原因，需要进一步研究。
