TY - JOUR
T1 - Temporal changes in patient characteristics and prior pharmacotherapy in patients undergoing radiofrequency ablation of atrial fibrillation
AU - Karasoy, Deniz
AU - Gislason, Gunnar Hilmar
AU - Hansen, Jim
AU - Olesen, Jonas Bjerring
AU - Torp-Pedersen, Christian
AU - Johannessen, Arne
AU - Hansen, Morten Lock
PY - 2013/5
Y1 - 2013/5
N2 - 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 CHA2DS2-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.
AB - 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 CHA2DS2-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.
U2 - 10.1093/europace/eus418
DO - 10.1093/europace/eus418
M3 - Journal article
C2 - 23284140
SN - 1099-5129
VL - 15
SP - 669
EP - 675
JO - Europace
JF - Europace
IS - 5
ER -
