Kristina Wasmer1, M Hochadel2, H Wieneke3, S G Spitzer4,5, J Brachmann6, F Straube7, J Tebbenjohanns8, G Groschup9, A Heisel10, T Lewalter11, J Senges2, L Eckardt12. 1. Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. wasmerk@ukmuenster.de. 2. Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen am Rhein, Germany. 3. Elisabeth-Krankenhaus Essen, Essen, Germany. 4. Praxisklinik Herz und Gefaesse, Dresden, Germany. 5. Brandenburg University of Technology Cottbus-Senftenberg, Cottbus-Senftenberg, Germany. 6. Department of Cardiology, Angiology, and Pneumology, Second Medical Clinic, Coburg Hospital, Coburg, Germany. 7. Munich Municipal Hospital Group, Heart Center Munich-Bogenhausen, Munich, Germany. 8. Klinikum Hildesheim, Hildesheim, Germany. 9. Klinikum Aschaffenburg, Aschaffenburg, Germany. 10. Klinikum Wilhelmshaven, Wilhelmshaven, Germany. 11. Department of Medicine-Cardiology and Intensive Care, Hospital Munich-Thalkirchen, Munich, Germany. 12. Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
Abstract
BACKGROUND: We aimed to compare patient characteristics and outcome of patients who had either undergone pulmonary vein isolation (PVI) or AV-node ablation (AVN) to control AF-related symptoms. METHODS: From the German Ablation Registry, we analyzed data of 4444 patients (95%) who had undergone PVI and 234 patients (5%) with AVN. RESULTS: AVN patients were on average 10 years older than PVI patients (71 ± 10 vs. 61 ± 10 years, p < 0.001) with 33% aged > 75 years. AVN patients had significantly more cardiovascular comorbidities (diabetes 21% vs. 8%, renal insufficiency 24% vs. 3%, underlying heart disease 80% vs. 36%, severely reduced left ventricular function 28% vs. 1%, all p < 0.001). Significantly more PVI patients had paroxysmal AF (63% vs. 18%, p < 0.001), and more AVN patients had long-standing persistent AF (44% vs. 7%, p < 0.001). At 1-year follow-up, mortality in the AVN group was much higher (Kaplan-Meier estimates 9.8% vs. 0.5%). 20% of PVI patients had undergone another ablation vs. 3% AVN patients (p < 0.001). Symptomatic improvement was equally achieved in about 80%. Re-hospitalization for cardiovascular reasons occurred significantly more often in PVI vs. AVN patients (31% vs. 18%, p < 0.001). CONCLUSION: In the large German Ablation Registry, AVN ablation was performed much less frequently than PVI for symptomatic treatment of AF and typically in older patients with more comorbidity. Symptomatic improvement was similar in both groups. Hospitalizations for cardiovascular reasons were lower in AVN patients despite older age and more cardiovascular comorbidities. 20% of PVI patients had undergone at least one re-ablation.
BACKGROUND: We aimed to compare patient characteristics and outcome of patients who had either undergone pulmonary vein isolation (PVI) or AV-node ablation (AVN) to control AF-related symptoms. METHODS: From the German Ablation Registry, we analyzed data of 4444 patients (95%) who had undergone PVI and 234 patients (5%) with AVN. RESULTS: AVN patients were on average 10 years older than PVI patients (71 ± 10 vs. 61 ± 10 years, p < 0.001) with 33% aged > 75 years. AVN patients had significantly more cardiovascular comorbidities (diabetes 21% vs. 8%, renal insufficiency 24% vs. 3%, underlying heart disease 80% vs. 36%, severely reduced left ventricular function 28% vs. 1%, all p < 0.001). Significantly more PVI patients had paroxysmal AF (63% vs. 18%, p < 0.001), and more AVN patients had long-standing persistent AF (44% vs. 7%, p < 0.001). At 1-year follow-up, mortality in the AVN group was much higher (Kaplan-Meier estimates 9.8% vs. 0.5%). 20% of PVI patients had undergone another ablation vs. 3% AVN patients (p < 0.001). Symptomatic improvement was equally achieved in about 80%. Re-hospitalization for cardiovascular reasons occurred significantly more often in PVI vs. AVN patients (31% vs. 18%, p < 0.001). CONCLUSION: In the large German Ablation Registry, AVN ablation was performed much less frequently than PVI for symptomatic treatment of AF and typically in older patients with more comorbidity. Symptomatic improvement was similar in both groups. Hospitalizations for cardiovascular reasons were lower in AVN patients despite older age and more cardiovascular comorbidities. 20% of PVI patients had undergone at least one re-ablation.
Authors: Kevin Willy; Kristina Wasmer; Dirk G Dechering; Julia Köbe; Philipp S Lange; Nils Bögeholz; Christian Ellermann; Florian Reinke; Gerrit Frommeyer; Lars Eckardt Journal: Clin Cardiol Date: 2020-10-19 Impact factor: 2.882
Authors: Charlotte Eitel; Hüseyin Ince; Johannes Brachmann; Karl-Heinz Kuck; Stephan Willems; Stefan G Spitzer; Juergen Tebbenjohanns; Leon Iden; Florian Straube; Matthias Hochadel; Jochen Senges; Roland R Tilz Journal: Clin Res Cardiol Date: 2021-06-09 Impact factor: 6.138
Authors: Shinwan Kany; Johannes Brachmann; Thorsten Lewalter; Karl-Heinz Kuck; Dietrich Andresen; Stephan Willems; Ellen Hoffmann; Lars Eckardt; Dierk Thomas; Matthias Hochadel; Jochen Senges; Andreas Metzner; Andreas Rillig Journal: Clin Res Cardiol Date: 2020-10-28 Impact factor: 5.460
Authors: Ann-Kathrin Rahm; Patrick Lugenbiel; Marco Ochs; Benjamin Meder; Dierk Thomas; Hugo A Katus; Eberhard Scholz Journal: Clin Res Cardiol Date: 2020-03-06 Impact factor: 5.460