Ola Olatunde, Gharacholou S Michael, Deshmukh Abhishek J, Valverde Arturo M, Scott Christopher G, Lee Alexander T, Del-Carpio Munoz Freddy
Department of Cardiovascular Diseases, Marshall University School of Medicine, Huntington, WV, USA.
Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA.
J Interv Card Electrophysiol. 2024 Sep 26. doi: 10.1007/s10840-024-01920-w.
Limited data exist on outcomes of atrial fibrillation (AF) catheter ablation based on hospital setting and, specifically, the availability of onsite cardiothoracic surgery (CTS). We aimed to describe the characteristics and outcomes of catheter ablation for AF performed at a facility with and without CTS.
This was a retrospective study of consecutive patients who underwent catheter ablation for AF at hospital with (CTS) and without cardiothoracic surgery (N-CTS) from January 2011 through December 2019. Clinical and procedural characteristics, complications, and 1-year outcomes, including clinical events and AF recurrence, were collected.
There were 326 unique patients who underwent an index AF ablation procedure: 206 CTS patients and 120 N-CTS patients. There were no differences in overall cardiac complications (2.5% vs. 5.8%), including mapping catheter entrapment requiring open-heart surgery (0% vs. 0.5%), pericardial effusion requiring pericardiocentesis (0.8% vs. 0.5%), hemopericardium (1.7% vs. 0.5%), acute myocardial infarction (0% vs. 1.0%), and sinus node injury (0% versus 0.5%) (all P values > .05) between N-CTS and CTS patients. Likewise, overall noncardiac complications (20.7% vs. 19.8%, P = .85), including bleeding, cerebrovascular accident, and phrenic or vagus nerve injury, were similar between N-CTS and CTS hospitals. Also, 1-year cumulative Kaplan-Meier estimates of overall AF recurrence (11.6% vs. 16.4%; log-rank P = 0.21; HR 1.47; 95% CI, 0.79-2.74) were not statistically significant between N-CTS and CTS hospitals.
Catheter ablation procedure is safe and effective regardless of onsite CTS presence, and there were no significant differences between the two hospital settings.
基于医院环境，特别是现场心胸外科手术（CTS）的可用性，关于心房颤动（AF）导管消融结果的数据有限。我们旨在描述在有和没有CTS的机构中进行AF导管消融的特征和结果。
这是一项对2011年1月至2019年12月期间在有CTS和没有心胸外科手术（N-CTS）的医院连续接受AF导管消融的患者进行的回顾性研究。收集了临床和手术特征、并发症以及1年的结果，包括临床事件和AF复发情况。
共有326例患者接受了首次AF消融手术：206例CTS患者和120例N-CTS患者。N-CTS组和CTS组患者在总体心脏并发症方面（2.5%对5.8%）没有差异，包括需要心脏直视手术的标测导管嵌顿（0%对0.5%）、需要心包穿刺的心包积液（0.8%对0.5%）、心包积血（1.7%对0.5%）、急性心肌梗死（0%对1.0%）和窦房结损伤（0%对0.5%）（所有P值＞0.05）。同样，N-CTS医院和CTS医院在总体非心脏并发症方面（20.7%对19.8%，P = 0.85）相似，包括出血、脑血管意外以及膈神经或迷走神经损伤。此外，N-CTS医院和CTS医院之间1年累积的AF总体复发的Kaplan-Meier估计值（11.6%对16.4%；对数秩检验P = 0.21；风险比1.47；95%置信区间，0.79 - 2.74）无统计学意义。
无论现场是否有CTS，导管消融手术都是安全有效的，并且两种医院环境之间没有显著差异。
