Over 10 years, radiofrequency ablation for atrial fibrillation was increasingly performed in older patients (median age 55 to 61) and without prior antiarrhythmic therapy (8.7% to 22.7%, P<0.0001).
Cohort (n=3,302)
Yes
How have patient characteristics and prior pharmacotherapy changed over time in patients undergoing radiofrequency ablation for atrial fibrillation?
Over a 10-year period in Denmark, radiofrequency ablation for atrial fibrillation was increasingly performed in older patients with higher comorbidity and without prior trial of antiarrhythmic therapy.
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.
Karasoy et al. (Wed,) conducted a cohort in Atrial fibrillation (n=3,302). Radiofrequency ablation vs. Temporal trends (2000-01 vs 2008-09) was evaluated on Temporal trends in patient characteristics and prior pharmacotherapy. Over 10 years, radiofrequency ablation for atrial fibrillation was increasingly performed in older patients (median age 55 to 61) and without prior antiarrhythmic therapy (8.7% to 22.7%, P<0.0001).