Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry
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 an...
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| Veröffentlicht in: | Clinical research in cardiology 2019-04, Vol.108 (4), p.395-401 |
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| creator | Wasmer, Kristina Hochadel, M. Wieneke, H. Spitzer, S. G. Brachmann, J. Straube, F. Tebbenjohanns, J. Groschup, G. Heisel, A. Lewalter, T. Senges, J. Eckardt, L. |
| description | 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
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
|
| doi_str_mv | 10.1007/s00392-018-1368-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2101268190</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2101268190</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-94aaa14dc219d07cb5d8ca1374693e5895d9d6a3599eddafcb50b129a5a8b65d3</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhhtR3A_9AV4k4MVL1nx0pzvehkV3hQFB1Guo7qTHLJ2kTdID89P8d2bsmRUET1VUPVX1Um9VvaLkhhLSvkuEcMkwoR2mXHSYPakuaScoJkKyp495V19UVyk9ENJQwuvn1QUnVNZ121xWv7bB73A20aF0cHMODlk3x7A3zviMwGs0Q7bHPJWYRhiyDR7BWGbQ5jv2QRsE_QR_yvt0g-ZlcsFDPKC9sR7ZFE7NMcTzkVIYEORoYUKj7aOdVuY9iiYtU05ojEVK_mHQXdEGHm3OJ76YnU05Hl5Uz0aYknl5itfVt48fvt7e4-3nu0-3my0eeMsyljUA0FoPjEpN2qFvdDcA5W0tJDdNJxsttQDeSGm0hrEApKdMQgNdLxrNr6u3697ylZ-LSVk5mwZTBHsTlqQYJZSJjkpS0Df_oA9hib6oO1JEtEIQWSi6UkMMKUUzqjlaV_6lKFFHX9Xqqyq-qqOvipWZ16fNS--Mfpw4G1kAtgKptPzOxL-n_7_1N-cQspg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2100676609</pqid></control><display><type>article</type><title>Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wasmer, Kristina ; Hochadel, M. ; Wieneke, H. ; Spitzer, S. G. ; Brachmann, J. ; Straube, F. ; Tebbenjohanns, J. ; Groschup, G. ; Heisel, A. ; Lewalter, T. ; Senges, J. ; Eckardt, L.</creator><creatorcontrib>Wasmer, Kristina ; Hochadel, M. ; Wieneke, H. ; Spitzer, S. G. ; Brachmann, J. ; Straube, F. ; Tebbenjohanns, J. ; Groschup, G. ; Heisel, A. ; Lewalter, T. ; Senges, J. ; Eckardt, L.</creatorcontrib><description><![CDATA[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.]]></description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-018-1368-2</identifier><identifier>PMID: 30194475</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Ablation ; Aged ; Atrial Fibrillation - mortality ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Atrioventricular Node - physiopathology ; Atrioventricular Node - surgery ; Cardiology ; Catheter Ablation - methods ; Control methods ; Coronary artery disease ; Data processing ; Diabetes mellitus ; Female ; Fibrillation ; Follow-Up Studies ; Germany - epidemiology ; Heart ; Heart diseases ; Heart Rate - physiology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Patient Satisfaction ; Patients ; Prospective Studies ; Pulmonary Veins - surgery ; Recurrence ; Registries ; Renal insufficiency ; Survival Rate - trends ; Time Factors ; Treatment Outcome ; Ventricle</subject><ispartof>Clinical research in cardiology, 2019-04, Vol.108 (4), p.395-401</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Clinical Research in Cardiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-94aaa14dc219d07cb5d8ca1374693e5895d9d6a3599eddafcb50b129a5a8b65d3</citedby><cites>FETCH-LOGICAL-c372t-94aaa14dc219d07cb5d8ca1374693e5895d9d6a3599eddafcb50b129a5a8b65d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-018-1368-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-018-1368-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30194475$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wasmer, Kristina</creatorcontrib><creatorcontrib>Hochadel, M.</creatorcontrib><creatorcontrib>Wieneke, H.</creatorcontrib><creatorcontrib>Spitzer, S. G.</creatorcontrib><creatorcontrib>Brachmann, J.</creatorcontrib><creatorcontrib>Straube, F.</creatorcontrib><creatorcontrib>Tebbenjohanns, J.</creatorcontrib><creatorcontrib>Groschup, G.</creatorcontrib><creatorcontrib>Heisel, A.</creatorcontrib><creatorcontrib>Lewalter, T.</creatorcontrib><creatorcontrib>Senges, J.</creatorcontrib><creatorcontrib>Eckardt, L.</creatorcontrib><title>Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description><![CDATA[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.]]></description><subject>Ablation</subject><subject>Aged</subject><subject>Atrial Fibrillation - mortality</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Atrioventricular Node - physiopathology</subject><subject>Atrioventricular Node - surgery</subject><subject>Cardiology</subject><subject>Catheter Ablation - methods</subject><subject>Control methods</subject><subject>Coronary artery disease</subject><subject>Data processing</subject><subject>Diabetes mellitus</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Follow-Up Studies</subject><subject>Germany - epidemiology</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Patient Satisfaction</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Pulmonary Veins - surgery</subject><subject>Recurrence</subject><subject>Registries</subject><subject>Renal insufficiency</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU2LFDEQhhtR3A_9AV4k4MVL1nx0pzvehkV3hQFB1Guo7qTHLJ2kTdID89P8d2bsmRUET1VUPVX1Um9VvaLkhhLSvkuEcMkwoR2mXHSYPakuaScoJkKyp495V19UVyk9ENJQwuvn1QUnVNZ121xWv7bB73A20aF0cHMODlk3x7A3zviMwGs0Q7bHPJWYRhiyDR7BWGbQ5jv2QRsE_QR_yvt0g-ZlcsFDPKC9sR7ZFE7NMcTzkVIYEORoYUKj7aOdVuY9iiYtU05ojEVK_mHQXdEGHm3OJ76YnU05Hl5Uz0aYknl5itfVt48fvt7e4-3nu0-3my0eeMsyljUA0FoPjEpN2qFvdDcA5W0tJDdNJxsttQDeSGm0hrEApKdMQgNdLxrNr6u3697ylZ-LSVk5mwZTBHsTlqQYJZSJjkpS0Df_oA9hib6oO1JEtEIQWSi6UkMMKUUzqjlaV_6lKFFHX9Xqqyq-qqOvipWZ16fNS--Mfpw4G1kAtgKptPzOxL-n_7_1N-cQspg</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Wasmer, Kristina</creator><creator>Hochadel, M.</creator><creator>Wieneke, H.</creator><creator>Spitzer, S. G.</creator><creator>Brachmann, J.</creator><creator>Straube, F.</creator><creator>Tebbenjohanns, J.</creator><creator>Groschup, G.</creator><creator>Heisel, A.</creator><creator>Lewalter, T.</creator><creator>Senges, J.</creator><creator>Eckardt, L.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20190401</creationdate><title>Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry</title><author>Wasmer, Kristina ; Hochadel, M. ; Wieneke, H. ; Spitzer, S. G. ; Brachmann, J. ; Straube, F. ; Tebbenjohanns, J. ; Groschup, G. ; Heisel, A. ; Lewalter, T. ; Senges, J. ; Eckardt, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-94aaa14dc219d07cb5d8ca1374693e5895d9d6a3599eddafcb50b129a5a8b65d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Ablation</topic><topic>Aged</topic><topic>Atrial Fibrillation - mortality</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Atrioventricular Node - physiopathology</topic><topic>Atrioventricular Node - surgery</topic><topic>Cardiology</topic><topic>Catheter Ablation - methods</topic><topic>Control methods</topic><topic>Coronary artery disease</topic><topic>Data processing</topic><topic>Diabetes mellitus</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Follow-Up Studies</topic><topic>Germany - epidemiology</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Patient Satisfaction</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Pulmonary Veins - surgery</topic><topic>Recurrence</topic><topic>Registries</topic><topic>Renal insufficiency</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wasmer, Kristina</creatorcontrib><creatorcontrib>Hochadel, M.</creatorcontrib><creatorcontrib>Wieneke, H.</creatorcontrib><creatorcontrib>Spitzer, S. G.</creatorcontrib><creatorcontrib>Brachmann, J.</creatorcontrib><creatorcontrib>Straube, F.</creatorcontrib><creatorcontrib>Tebbenjohanns, J.</creatorcontrib><creatorcontrib>Groschup, G.</creatorcontrib><creatorcontrib>Heisel, A.</creatorcontrib><creatorcontrib>Lewalter, T.</creatorcontrib><creatorcontrib>Senges, J.</creatorcontrib><creatorcontrib>Eckardt, L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wasmer, Kristina</au><au>Hochadel, M.</au><au>Wieneke, H.</au><au>Spitzer, S. G.</au><au>Brachmann, J.</au><au>Straube, F.</au><au>Tebbenjohanns, J.</au><au>Groschup, G.</au><au>Heisel, A.</au><au>Lewalter, T.</au><au>Senges, J.</au><au>Eckardt, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>108</volume><issue>4</issue><spage>395</spage><epage>401</epage><pages>395-401</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract><![CDATA[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.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30194475</pmid><doi>10.1007/s00392-018-1368-2</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2019-04, Vol.108 (4), p.395-401 |
| issn | 1861-0684 1861-0692 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2101268190 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Ablation Aged Atrial Fibrillation - mortality Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Atrioventricular Node - physiopathology Atrioventricular Node - surgery Cardiology Catheter Ablation - methods Control methods Coronary artery disease Data processing Diabetes mellitus Female Fibrillation Follow-Up Studies Germany - epidemiology Heart Heart diseases Heart Rate - physiology Humans Male Medicine Medicine & Public Health Middle Aged Original Paper Patient Satisfaction Patients Prospective Studies Pulmonary Veins - surgery Recurrence Registries Renal insufficiency Survival Rate - trends Time Factors Treatment Outcome Ventricle |
| title | Long-term symptom improvement and patient satisfaction after AV-node ablation vs. pulmonary vein isolation for symptomatic atrial fibrillation: results from the German Ablation Registry |
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