Ablation of Atrial Fibrillation in Patients with Hypertension-An Analysis from the German Ablation Registry.

arterial hypertension atrial fibrillation catheter ablation complications long-term follow-up registry

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
27 Jul 2020
Historique:
received: 24 06 2020
revised: 21 07 2020
accepted: 22 07 2020
entrez: 31 7 2020
pubmed: 31 7 2020
medline: 31 7 2020
Statut: epublish

Résumé

Hypertension (HTN) constitutes a risk factor for the development of atrial fibrillation (AF), as well as for thromboembolic and bleeding events. We analysed the outcome after catheter ablation of AF in HTN in a cohort from the prospective multicenter German Ablation Registry. Between 03/2008 and 01/2010, 626 patients undergoing AF-ablation were analysed. Patients diagnosed with HTN ( Patients with HTN were older and more often presented with persistent forms of AF and cardiac comorbidities. Major and moderate in-hospital complications were low. At long-term follow-up, major cardiovascular events were rare in both groups. Rates of AF-recurrence, freedom from antiarrhythmic medication and repeat ablation were not statistically different between groups. Most patients reported improvement of symptoms and satisfaction with the treatment. However, patients with HTN more frequently complained of dyspnea of New York Heart Association (NYHA) class ≥ II and angina. They were more often rehospitalized, particularly when persistent AF had been diagnosed. Catheter ablation of AF is associated with low complication rates and favorable arrhythmia-related results in patients with HTN. Residual clinical symptoms may be due to cardiac comorbidities and require additional attention in this important subgroup of AF-patients.

Sections du résumé

BACKGROUND BACKGROUND
Hypertension (HTN) constitutes a risk factor for the development of atrial fibrillation (AF), as well as for thromboembolic and bleeding events. We analysed the outcome after catheter ablation of AF in HTN in a cohort from the prospective multicenter German Ablation Registry.
METHODS METHODS
Between 03/2008 and 01/2010, 626 patients undergoing AF-ablation were analysed. Patients diagnosed with HTN (
RESULTS RESULTS
Patients with HTN were older and more often presented with persistent forms of AF and cardiac comorbidities. Major and moderate in-hospital complications were low. At long-term follow-up, major cardiovascular events were rare in both groups. Rates of AF-recurrence, freedom from antiarrhythmic medication and repeat ablation were not statistically different between groups. Most patients reported improvement of symptoms and satisfaction with the treatment. However, patients with HTN more frequently complained of dyspnea of New York Heart Association (NYHA) class ≥ II and angina. They were more often rehospitalized, particularly when persistent AF had been diagnosed.
CONCLUSION CONCLUSIONS
Catheter ablation of AF is associated with low complication rates and favorable arrhythmia-related results in patients with HTN. Residual clinical symptoms may be due to cardiac comorbidities and require additional attention in this important subgroup of AF-patients.

Identifiants

pubmed: 32727136
pii: jcm9082402
doi: 10.3390/jcm9082402
pmc: PMC7463680
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : Stiftung Institut für Herzinfarktforschung
ID : unrestricted grant
Organisme : Medtronic
ID : unrestricted grant
Organisme : Biosense Webster
ID : unrestricted grand
Organisme : Biotronik
ID : unrestricted grant

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Auteurs

Maura M Zylla (MM)

Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany.

Matthias Hochadel (M)

Stiftung Institut für Herzinfarktforschung, IHF, Bremserstraße 79, 67063 Ludwigshafen, Germany.

Dietrich Andresen (D)

Department of Cardiology, Vivantes Hospital, Klinikum am Urban, Dieffenbachstraße 1, 10967 Berlin, Germany.

Johannes Brachmann (J)

Department of Cardiology, Hospital Coburg, Ketschendorfer Str. 33, 96450 Coburg, Germany.

Lars Eckardt (L)

Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.

Ellen Hoffmann (E)

Department of Cardiology/Intensive Care Medicine, Heart Center Munich-Bogenhausen, Englschalkinger Str. 77, 81925 Munich, Germany.

Karl-Heinz Kuck (KH)

Department of Cardiology, Asklepios Hospital St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany.

Thorsten Lewalter (T)

Klinik für Kardiologie und Internist, Intensivmedizin, Peter Osypka Herzzentrum, Internistisches Klinikum München Süd, Am Isarkanal 36, 81379 Munich, Germany.

Burghard Schumacher (B)

Department of Cardiology, Herz- und Gefäßklinik, Salzburger Leite 1, 97616 Bad Neustadt/Saale, Germany.

Stefan G Spitzer (SG)

Praxisklinik Herz und Gefäße, Forststraße 3, 01099 Dresden, Germany.
Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany.

Stephan Willems (S)

Department of Cardiology/Electrophysiology, University Heart Center, Martinistraße 52, 20251 Hamburg, Germany.

Jochen Senges (J)

Stiftung Institut für Herzinfarktforschung, IHF, Bremserstraße 79, 67063 Ludwigshafen, Germany.

Hugo A Katus (HA)

Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany.

Dierk Thomas (D)

Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
HCR (Heidelberg Center for Heart Rhythm Disorders), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Medical University Hospital Heidelberg, 69120 Heidelberg, Germany.

Classifications MeSH