Roland Richard Tilz1,2,3, Nikolaos Dagres4, Elena Arbelo5,6, Carina Blomström-Lundqvist7, Harry J Crijns8,9, Paulus Kirchhof10, Josef Kautzner11, Pier Luigi Temporelli12, Cécile Laroche13, Paul R Roberts14, Steen Pehrson15, Gregory Y H Lip16,17, Josep Brugada18, Luigi Tavazzi19. 1. Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center, Medical Clinic II, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany. 2. Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany. 3. DZHK (German Center for Cardiovascular Research), Partner Site, Hamburg/Kiel/Lübeck, Berlin, Germany. 4. Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. 5. Department of Cardiology, Cardiovascular Institute, Hospital Clinic de Barcelona, Universitat de Barcelona, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain. 6. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 7. Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden. 8. Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands. 9. Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands. 10. Institute of Cardiovascular Sciences, University of Birmingham and SWBH and UHB NHS Trusts, Birmingham, Great Britain. 11. Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. 12. Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy. 13. EURObservational Research Programme (EORP), ESC, Sophia-Antipolis, France. 14. University Hospital Southampton NHS Trust, Southampton, Great Britain. 15. Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark. 16. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, Great Britain. 17. Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark. 18. Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Barcelona, Spain. 19. Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy.
Abstract
AIMS: Rhythm control management in patients with atrial fibrillation (AF) may be unequal across Europe. The aim of this study was to investigate how selective the patient cohort referred for AF ablation is, as compared to the general AF population in Europe, and to describe the governing mechanisms for such selection. METHODS AND RESULTS: Descriptive comparative statistical analyses of the baseline characteristics were performed between the cohorts of Atrial Fibrillation Ablation Long-Term (ESC EORP AFA-LT) registry, designed to provide a picture of contemporary real-world AF ablation, and the AF population from the AF-General (ESC EORP AF-Gen) pilot registry. Data collection was performed using a web-based system. In the AFA and in the Atrial Fibrillation General (AFG) pilot registries, 3593 and 3049 patients were enrolled, respectively. Patients who underwent AF ablation were younger, more commonly male, and had significantly less comorbidities. Atrial Fibrillation Ablation patients often presented without comorbidities, resulting in a lower risk of stroke (CHA2DS2-VASc ≥5: 2.9% vs. 24.5%, all P < 0.001) and bleeding (HAS-BLED ≥2: 8.5% vs. 40.5%, P < 0.001) but with European Heart Rhythm Association (EHRA) scores >1 and more prevalent AF-related symptoms such as palpitations, fatigue, and weakness (all P < 0.001) as compared to the general AF patients. Atrial Fibrillation Ablation patients were significantly more often male, had higher left ventricular ejection fraction (59.5% vs. 52.4%) and smaller left atrial size on echocardiogram (P < 0.001 each). CONCLUSION: The comparison of the patient cohorts in the AFA and AFG registries showed that AF ablation in European clinical practice is mostly performed in relatively young, symptomatic and relatively healthy patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Rhythm control management in patients with atrial fibrillation (AF) may be unequal across Europe. The aim of this study was to investigate how selective the patient cohort referred for AF ablation is, as compared to the general AF population in Europe, and to describe the governing mechanisms for such selection. METHODS AND RESULTS: Descriptive comparative statistical analyses of the baseline characteristics were performed between the cohorts of Atrial Fibrillation Ablation Long-Term (ESC EORP AFA-LT) registry, designed to provide a picture of contemporary real-world AF ablation, and the AF population from the AF-General (ESC EORP AF-Gen) pilot registry. Data collection was performed using a web-based system. In the AFA and in the Atrial Fibrillation General (AFG) pilot registries, 3593 and 3049 patients were enrolled, respectively. Patients who underwent AF ablation were younger, more commonly male, and had significantly less comorbidities. Atrial Fibrillation Ablation patients often presented without comorbidities, resulting in a lower risk of stroke (CHA2DS2-VASc ≥5: 2.9% vs. 24.5%, all P < 0.001) and bleeding (HAS-BLED ≥2: 8.5% vs. 40.5%, P < 0.001) but with European Heart Rhythm Association (EHRA) scores >1 and more prevalent AF-related symptoms such as palpitations, fatigue, and weakness (all P < 0.001) as compared to the general AF patients. Atrial Fibrillation Ablation patients were significantly more often male, had higher left ventricular ejection fraction (59.5% vs. 52.4%) and smaller left atrial size on echocardiogram (P < 0.001 each). CONCLUSION: The comparison of the patient cohorts in the AFA and AFG registries showed that AF ablation in European clinical practice is mostly performed in relatively young, symptomatic and relatively healthy patients. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Krzysztof Myrda; Piotr Buchta; Aleksandra Błachut; Michał Skrzypek; Mariusz Gąsior Journal: Medicina (Kaunas) Date: 2022-01-26 Impact factor: 2.430