A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes
Abstract Aims Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adv...
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| Veröffentlicht in: | European heart journal 2019-03, Vol.40 (10), p.820-830 |
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| creator | Holmqvist, Fredrik Kesek, Milos Englund, Anders Blomström-Lundqvist, Carina Karlsson, Lars O Kennebäck, Göran Poçi, Dritan Samo-Ayou, Romeo Sigurjónsdóttir, Runa Ringborn, Michael Herczku, Csaba Carlson, Jonas Fengsrud, Espen Tabrizi, Fariborz Höglund, Niklas Lönnerholm, Stefan Kongstad, Ole Jönsson, Anders Insulander, Per |
| description | Abstract
Aims
Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.
Methods and Results
Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff–Parkinson–White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7–7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P |
| doi_str_mv | 10.1093/eurheartj/ehy709 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_484036</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehy709</oup_id><sourcerecordid>2136067543</sourcerecordid><originalsourceid>FETCH-LOGICAL-c689t-9e6bdbe2fba8c7121981d1d26c09fa60d22fd9e66b6c82fdf655070114fba26e3</originalsourceid><addsrcrecordid>eNqNkk1v1DAQhiMEokvhzgnliAShHjt2Yg5Iq_IprcSBD3GzHHuyccnGWzuh2n-PlywLPbRwGNkaP-8749Fk2WMgL4BIdoZT6FCH8eIMu11F5J1sAZzSQoqS380WBCQvhKi_nWQPYrwghNQCxP3shJGSU8FgkallbtFoi7lvc6PHDkcMuW56PTo_zMlgnTa5DqHbjd3G6Zi7If90hRaHl3_QbdBmdAZjrgeb-2k0foPxYXav1X3ER4fzNPvy9s3n8_fF6uO7D-fLVWFELcdComhsg7RtdG0qoCBrsGCpMES2WhBLaWsTJBph6nRtBeekIgBlUlCB7DQrZt94hdupUdvgNjrslNdOHVLf0w1VWZeEicSvbuT7aZuiSbEXGKgMtyAV4U27lxulQVdK1w1wViIAY7eWXye7lFr_cqMVS4NP_PMb-dfu61L5sFbTpJioKOX_h_swqYql393azRHv3aSA81pWiX818wneoDU4jEH312TXXwbXqbX_oUSqVnKZDJ4eDIK_nDCOauOiwb7XA_opKgpMEFHxct8bmVETfIwB22MZIGq_1Oq41Gpe6iR58nd7R8HvLU7AsxnwadT_tPsJZJ8JWw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2136067543</pqid></control><display><type>article</type><title>A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SWEPUB Freely available online</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Holmqvist, Fredrik ; Kesek, Milos ; Englund, Anders ; Blomström-Lundqvist, Carina ; Karlsson, Lars O ; Kennebäck, Göran ; Poçi, Dritan ; Samo-Ayou, Romeo ; Sigurjónsdóttir, Runa ; Ringborn, Michael ; Herczku, Csaba ; Carlson, Jonas ; Fengsrud, Espen ; Tabrizi, Fariborz ; Höglund, Niklas ; Lönnerholm, Stefan ; Kongstad, Ole ; Jönsson, Anders ; Insulander, Per</creator><creatorcontrib>Holmqvist, Fredrik ; Kesek, Milos ; Englund, Anders ; Blomström-Lundqvist, Carina ; Karlsson, Lars O ; Kennebäck, Göran ; Poçi, Dritan ; Samo-Ayou, Romeo ; Sigurjónsdóttir, Runa ; Ringborn, Michael ; Herczku, Csaba ; Carlson, Jonas ; Fengsrud, Espen ; Tabrizi, Fariborz ; Höglund, Niklas ; Lönnerholm, Stefan ; Kongstad, Ole ; Jönsson, Anders ; Insulander, Per ; Sahlgrenska akademin ; Institute of Medicine, Department of Molecular and Clinical Medicine ; Institutionen för medicin, avdelningen för molekylär och klinisk medicin ; Göteborgs universitet ; Gothenburg University ; Sahlgrenska Academy</creatorcontrib><description>Abstract
Aims
Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.
Methods and Results
Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff–Parkinson–White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7–7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%).
Conclusion
Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.</description><identifier>ISSN: 0195-668X</identifier><identifier>ISSN: 1522-9645</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehy709</identifier><identifier>PMID: 30452631</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Adverse events ; Aged ; Arrhythmias, Cardiac - epidemiology ; Arrhythmias, Cardiac - surgery ; Cardiac and Cardiovascular Systems ; Cardiology ; Catheter ablation ; Catheter Ablation - adverse effects ; Catheter Ablation - statistics & numerical data ; Clinical Medicine ; Clinical Research ; Cohort Studies ; Editor's Choice ; Female ; Humans ; Kardiologi ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Middle Aged ; Outcome ; Reoperation - statistics & numerical data ; Sweden - epidemiology ; Treatment Outcome</subject><ispartof>European heart journal, 2019-03, Vol.40 (10), p.820-830</ispartof><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology. 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c689t-9e6bdbe2fba8c7121981d1d26c09fa60d22fd9e66b6c82fdf655070114fba26e3</citedby><cites>FETCH-LOGICAL-c689t-9e6bdbe2fba8c7121981d1d26c09fa60d22fd9e66b6c82fdf655070114fba26e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,551,777,781,882,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30452631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-155897$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-73403$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-367225$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/273263$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/c17c5d19-05bf-484c-a1a7-a8b1534e1133$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140539403$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Holmqvist, Fredrik</creatorcontrib><creatorcontrib>Kesek, Milos</creatorcontrib><creatorcontrib>Englund, Anders</creatorcontrib><creatorcontrib>Blomström-Lundqvist, Carina</creatorcontrib><creatorcontrib>Karlsson, Lars O</creatorcontrib><creatorcontrib>Kennebäck, Göran</creatorcontrib><creatorcontrib>Poçi, Dritan</creatorcontrib><creatorcontrib>Samo-Ayou, Romeo</creatorcontrib><creatorcontrib>Sigurjónsdóttir, Runa</creatorcontrib><creatorcontrib>Ringborn, Michael</creatorcontrib><creatorcontrib>Herczku, Csaba</creatorcontrib><creatorcontrib>Carlson, Jonas</creatorcontrib><creatorcontrib>Fengsrud, Espen</creatorcontrib><creatorcontrib>Tabrizi, Fariborz</creatorcontrib><creatorcontrib>Höglund, Niklas</creatorcontrib><creatorcontrib>Lönnerholm, Stefan</creatorcontrib><creatorcontrib>Kongstad, Ole</creatorcontrib><creatorcontrib>Jönsson, Anders</creatorcontrib><creatorcontrib>Insulander, Per</creatorcontrib><creatorcontrib>Sahlgrenska akademin</creatorcontrib><creatorcontrib>Institute of Medicine, Department of Molecular and Clinical Medicine</creatorcontrib><creatorcontrib>Institutionen för medicin, avdelningen för molekylär och klinisk medicin</creatorcontrib><creatorcontrib>Göteborgs universitet</creatorcontrib><creatorcontrib>Gothenburg University</creatorcontrib><creatorcontrib>Sahlgrenska Academy</creatorcontrib><title>A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Abstract
Aims
Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.
Methods and Results
Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff–Parkinson–White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7–7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%).
Conclusion
Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.</description><subject>Adult</subject><subject>Adverse events</subject><subject>Aged</subject><subject>Arrhythmias, Cardiac - epidemiology</subject><subject>Arrhythmias, Cardiac - surgery</subject><subject>Cardiac and Cardiovascular Systems</subject><subject>Cardiology</subject><subject>Catheter ablation</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - statistics & numerical data</subject><subject>Clinical Medicine</subject><subject>Clinical Research</subject><subject>Cohort Studies</subject><subject>Editor's Choice</subject><subject>Female</subject><subject>Humans</subject><subject>Kardiologi</subject><subject>Klinisk medicin</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Outcome</subject><subject>Reoperation - statistics & numerical data</subject><subject>Sweden - epidemiology</subject><subject>Treatment Outcome</subject><issn>0195-668X</issn><issn>1522-9645</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqNkk1v1DAQhiMEokvhzgnliAShHjt2Yg5Iq_IprcSBD3GzHHuyccnGWzuh2n-PlywLPbRwGNkaP-8749Fk2WMgL4BIdoZT6FCH8eIMu11F5J1sAZzSQoqS380WBCQvhKi_nWQPYrwghNQCxP3shJGSU8FgkallbtFoi7lvc6PHDkcMuW56PTo_zMlgnTa5DqHbjd3G6Zi7If90hRaHl3_QbdBmdAZjrgeb-2k0foPxYXav1X3ER4fzNPvy9s3n8_fF6uO7D-fLVWFELcdComhsg7RtdG0qoCBrsGCpMES2WhBLaWsTJBph6nRtBeekIgBlUlCB7DQrZt94hdupUdvgNjrslNdOHVLf0w1VWZeEicSvbuT7aZuiSbEXGKgMtyAV4U27lxulQVdK1w1wViIAY7eWXye7lFr_cqMVS4NP_PMb-dfu61L5sFbTpJioKOX_h_swqYql393azRHv3aSA81pWiX818wneoDU4jEH312TXXwbXqbX_oUSqVnKZDJ4eDIK_nDCOauOiwb7XA_opKgpMEFHxct8bmVETfIwB22MZIGq_1Oq41Gpe6iR58nd7R8HvLU7AsxnwadT_tPsJZJ8JWw</recordid><startdate>20190307</startdate><enddate>20190307</enddate><creator>Holmqvist, Fredrik</creator><creator>Kesek, Milos</creator><creator>Englund, Anders</creator><creator>Blomström-Lundqvist, Carina</creator><creator>Karlsson, Lars O</creator><creator>Kennebäck, Göran</creator><creator>Poçi, Dritan</creator><creator>Samo-Ayou, Romeo</creator><creator>Sigurjónsdóttir, Runa</creator><creator>Ringborn, Michael</creator><creator>Herczku, Csaba</creator><creator>Carlson, Jonas</creator><creator>Fengsrud, Espen</creator><creator>Tabrizi, Fariborz</creator><creator>Höglund, Niklas</creator><creator>Lönnerholm, Stefan</creator><creator>Kongstad, Ole</creator><creator>Jönsson, Anders</creator><creator>Insulander, Per</creator><general>Oxford University Press</general><scope>TOX</scope><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>7X8</scope><scope>5PM</scope><scope>ABXSW</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DG8</scope><scope>ZZAVC</scope><scope>AABEP</scope><scope>D91</scope><scope>ACNBI</scope><scope>DF2</scope><scope>F1U</scope><scope>AGCHP</scope><scope>D95</scope></search><sort><creationdate>20190307</creationdate><title>A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes</title><author>Holmqvist, Fredrik ; Kesek, Milos ; Englund, Anders ; Blomström-Lundqvist, Carina ; Karlsson, Lars O ; Kennebäck, Göran ; Poçi, Dritan ; Samo-Ayou, Romeo ; Sigurjónsdóttir, Runa ; Ringborn, Michael ; Herczku, Csaba ; Carlson, Jonas ; Fengsrud, Espen ; Tabrizi, Fariborz ; Höglund, Niklas ; Lönnerholm, Stefan ; Kongstad, Ole ; Jönsson, Anders ; Insulander, Per</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c689t-9e6bdbe2fba8c7121981d1d26c09fa60d22fd9e66b6c82fdf655070114fba26e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Adverse events</topic><topic>Aged</topic><topic>Arrhythmias, Cardiac - epidemiology</topic><topic>Arrhythmias, Cardiac - surgery</topic><topic>Cardiac and Cardiovascular Systems</topic><topic>Cardiology</topic><topic>Catheter ablation</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - statistics & numerical data</topic><topic>Clinical Medicine</topic><topic>Clinical Research</topic><topic>Cohort Studies</topic><topic>Editor's Choice</topic><topic>Female</topic><topic>Humans</topic><topic>Kardiologi</topic><topic>Klinisk medicin</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>Outcome</topic><topic>Reoperation - statistics & numerical data</topic><topic>Sweden - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holmqvist, Fredrik</creatorcontrib><creatorcontrib>Kesek, Milos</creatorcontrib><creatorcontrib>Englund, Anders</creatorcontrib><creatorcontrib>Blomström-Lundqvist, Carina</creatorcontrib><creatorcontrib>Karlsson, Lars O</creatorcontrib><creatorcontrib>Kennebäck, Göran</creatorcontrib><creatorcontrib>Poçi, Dritan</creatorcontrib><creatorcontrib>Samo-Ayou, Romeo</creatorcontrib><creatorcontrib>Sigurjónsdóttir, Runa</creatorcontrib><creatorcontrib>Ringborn, Michael</creatorcontrib><creatorcontrib>Herczku, Csaba</creatorcontrib><creatorcontrib>Carlson, Jonas</creatorcontrib><creatorcontrib>Fengsrud, Espen</creatorcontrib><creatorcontrib>Tabrizi, Fariborz</creatorcontrib><creatorcontrib>Höglund, Niklas</creatorcontrib><creatorcontrib>Lönnerholm, Stefan</creatorcontrib><creatorcontrib>Kongstad, Ole</creatorcontrib><creatorcontrib>Jönsson, Anders</creatorcontrib><creatorcontrib>Insulander, Per</creatorcontrib><creatorcontrib>Sahlgrenska akademin</creatorcontrib><creatorcontrib>Institute of Medicine, Department of Molecular and Clinical Medicine</creatorcontrib><creatorcontrib>Institutionen för medicin, avdelningen för molekylär och klinisk medicin</creatorcontrib><creatorcontrib>Göteborgs universitet</creatorcontrib><creatorcontrib>Gothenburg University</creatorcontrib><creatorcontrib>Sahlgrenska Academy</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Linköpings universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Linköpings universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Örebro universitet full text</collection><collection>SWEPUB Örebro universitet</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Lunds universitet full text</collection><collection>SWEPUB Lunds universitet</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holmqvist, Fredrik</au><au>Kesek, Milos</au><au>Englund, Anders</au><au>Blomström-Lundqvist, Carina</au><au>Karlsson, Lars O</au><au>Kennebäck, Göran</au><au>Poçi, Dritan</au><au>Samo-Ayou, Romeo</au><au>Sigurjónsdóttir, Runa</au><au>Ringborn, Michael</au><au>Herczku, Csaba</au><au>Carlson, Jonas</au><au>Fengsrud, Espen</au><au>Tabrizi, Fariborz</au><au>Höglund, Niklas</au><au>Lönnerholm, Stefan</au><au>Kongstad, Ole</au><au>Jönsson, Anders</au><au>Insulander, Per</au><aucorp>Sahlgrenska akademin</aucorp><aucorp>Institute of Medicine, Department of Molecular and Clinical Medicine</aucorp><aucorp>Institutionen för medicin, avdelningen för molekylär och klinisk medicin</aucorp><aucorp>Göteborgs universitet</aucorp><aucorp>Gothenburg University</aucorp><aucorp>Sahlgrenska Academy</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2019-03-07</date><risdate>2019</risdate><volume>40</volume><issue>10</issue><spage>820</spage><epage>830</epage><pages>820-830</pages><issn>0195-668X</issn><issn>1522-9645</issn><eissn>1522-9645</eissn><abstract>Abstract
Aims
Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.
Methods and Results
Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff–Parkinson–White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7–7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%).
Conclusion
Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30452631</pmid><doi>10.1093/eurheartj/ehy709</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-668X |
| ispartof | European heart journal, 2019-03, Vol.40 (10), p.820-830 |
| issn | 0195-668X 1522-9645 1522-9645 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_484036 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Adverse events Aged Arrhythmias, Cardiac - epidemiology Arrhythmias, Cardiac - surgery Cardiac and Cardiovascular Systems Cardiology Catheter ablation Catheter Ablation - adverse effects Catheter Ablation - statistics & numerical data Clinical Medicine Clinical Research Cohort Studies Editor's Choice Female Humans Kardiologi Klinisk medicin Male Medical and Health Sciences Medicin och hälsovetenskap Middle Aged Outcome Reoperation - statistics & numerical data Sweden - epidemiology Treatment Outcome |
| title | A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T04%3A22%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20decade%20of%20catheter%20ablation%20of%20cardiac%20arrhythmias%20in%20Sweden:%20ablation%20practices%20and%20outcomes&rft.jtitle=European%20heart%20journal&rft.au=Holmqvist,%20Fredrik&rft.aucorp=Sahlgrenska%20akademin&rft.date=2019-03-07&rft.volume=40&rft.issue=10&rft.spage=820&rft.epage=830&rft.pages=820-830&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/eurheartj/ehy709&rft_dat=%3Cproquest_swepu%3E2136067543%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2136067543&rft_id=info:pmid/30452631&rft_oup_id=10.1093/eurheartj/ehy709&rfr_iscdi=true |