Show simple item record

Catheter Ablation of Atrial Fibrillation in U.S. Community Practice--Results From Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).

dc.contributor.author Holmqvist, Fredrik
dc.contributor.author Simon, DaJuanicia
dc.contributor.author Steinberg, Benjamin A
dc.contributor.author Hong, Seok Jae
dc.contributor.author Kowey, Peter R
dc.contributor.author Reiffel, James A
dc.contributor.author Naccarelli, Gerald V
dc.contributor.author Chang, Paul
dc.contributor.author Gersh, Bernard J
dc.contributor.author Peterson, Eric D
dc.contributor.author Piccini, Jonathan P
dc.contributor.author ORBIT‐AF Investigators
dc.coverage.spatial England
dc.date.accessioned 2017-07-06T14:12:46Z
dc.date.available 2017-07-06T14:12:46Z
dc.date.issued 2015-05-21
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/25999401
dc.identifier JAHA.115.001901
dc.identifier.uri https://hdl.handle.net/10161/14999
dc.description.abstract BACKGROUND: The characteristics of patients undergoing atrial fibrillation (AF) ablation and subsequent outcomes in community practice are not well described. METHODS AND RESULTS: Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), we investigated the prevalence and impact of catheter ablation of AF. Among 9935 patients enrolled, 5.3% had previous AF ablation. Patients with AF ablation were significantly younger, more frequently male, and had less anemia, chronic obstructive pulmonary disease, and previous myocardial infarction (P<0.05 for all analyses) than those without previous catheter ablation of AF. Ablated patients were more likely to have a family history of AF, obstructive sleep apnea, paroxysmal AF, and moderate-to-severe symptoms (P<0.0001 for all analyses). Patients with previous ablation were more often in sinus rhythm on entry into the registry (52% vs. 32%; P<0.0001). Despite previous ablation, 46% in the ablation group were still on antiarrhythmic therapy. Oral anticoagulation was prescribed in 75% of those with previous ablation versus 76% in those without previous ablation (P=0.5). The adjusted risk of death (hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.52 to 1.18; P=0.2) and cardiovascular (CV) hospitalization (HR, 1.06; 95% CI, 0.90 to 1.26; P=0.5) were similar in both groups. Patients with incident AF ablation had higher risk of subsequent CV hospitalization than matched patients without incident ablation (HR, 1.67; 95% CI, 1.24 to 2.26; P=0.0008). CONCLUSIONS: In U.S. clinical practice, a minority of patients with AF are managed with catheter ablation. Subsequent to ablation, there were no significant differences in oral anticoagulation use or outcomes, including stroke/non-central nervous system embolism/transient ischemic attack or death. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01165710.
dc.language eng
dc.publisher Ovid Technologies (Wolters Kluwer Health)
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.115.001901
dc.subject anticoagulants
dc.subject atrial fibrillation
dc.subject catheter ablation
dc.subject morbidity
dc.subject survival
dc.subject Aged
dc.subject Anticoagulants
dc.subject Atrial Fibrillation
dc.subject Catheter Ablation
dc.subject Female
dc.subject Hospitalization
dc.subject Hospitals, Community
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Registries
dc.subject Risk Factors
dc.subject Treatment Outcome
dc.subject United States
dc.title Catheter Ablation of Atrial Fibrillation in U.S. Community Practice--Results From Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).
dc.type Journal article
duke.contributor.id Steinberg, Benjamin A|0538580
duke.contributor.id Peterson, Eric D|0130909
duke.contributor.id Piccini, Jonathan P|0373399
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/25999401
pubs.issue 5
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 4
dc.identifier.eissn 2047-9980
duke.contributor.orcid Peterson, Eric D|0000-0002-5415-4721


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record