Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Outcomes in patients experiencing complications associated with atrial fibrillation ablation: data from the German Ablation Registry
S. Kany1, K.-H. Kuck2, J. Brachmann3, D. Andresen4, S. Willems5, L. Eckardt6, M. Hochadel7, J. Senges8, A. Metzner9, A. Rillig9
1Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg; 2Kardiologie, LANS Cardio Hamburg, Hamburg; 3Medical School / Regiomed GmbH, Coburg; 4Klinik für Innere Medizin und Angiologie, Evangelisches Krankenhaus Hubertus, Berlin; 5Kardiologie, Asklepios Klinik St. Georg, Hamburg; 6Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster, Münster; 7Medizinische Klinik B, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein; 8Stiftung Institut für Herzinfarktforschung, Ludwigshafen am Rhein; 9Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg;

Background: This study aims to evaluate the clinical and patient-reported outcomes in patients undergoing atrial fibrillation (AF) ablation with moderate or severe complications (group I) compared to patients without complications (group II).


Methods: Analysis of AF patients treated with catheter ablation and included in the prospective, multicentre German Ablation Registry.


Results: A total of 3865 patients were included in this analysis (table 1). Group I consisted of 158 patients and group II of 3707 patients. Patients in group I were more likely to be female (46.8% vs 31.4%, p < 0.001) and older (65.5 years vs 60.4 years, p < 0.001). Acute procedural success rate (92.4% vs 96.1%, p = 0.019) was lower and recurrence rate before discharge significantly higher in group I (15.8% vs 6.5%, p < 0.001). Hospital stays were longer in patients with moderate to severe complications (6 days vs 3 days, p < 0.001). The in-hospital rate of death, myocardial infarction (MI), stroke or major bleeding was 29.9% in group I. Follow-up was obtained in most patients after a mean of 496 days and 468 days, respectively. No differences were observed in death (1.3% vs 0.4%, p = 0.13) or death and MI (1.3% vs 0.6%, p = 0.26) during follow-up. However, during the follow-up a composite outcome of death, MI, stroke, or major bleeding (8.5% vs 1.5%, p < 0.001) was significantly higher in patients with moderate to severe complications. Patient were still feeling safe during treatment regardless of complications (88.4 % vs 94.0%, p = 0.14) and the majority would choose the same clinic again for further treatment (90.7% vs 92.9%, p = 0.59). Patients reported no or improved symptoms in both cohorts (77.3% vs 78.6%) without significant differences. Likewise, patients perceived treatment to be successful (53.5% vs 62.8%) or partially successful (27.9% vs 21.6%) to a high extent.


Conclusion:  Patients with moderate or major complications after AF ablation are more likely to be older and female. In these patients, cardiovascular events after one-year are more common, however, patient satisfaction and symptom relief are high and comparable to those without complications.

 
https://dgk.org/kongress_programme/jt2022/aP1916.html