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Long-Term Survival Following Radiofrequency Catheter Ablation of Atrioventricular Junction for Atrial Fibrillation: Clinical and Ablation Determinants of Mortality

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Abstract

Background: For patients with drug-refractory atrial fibrillation, radiofrequency catheter ablation of the atrioventricular junction and pacemaker implantation is a nonpharmacologic option routinely used nowadays. Few data are available on the long-term survival following the procedure or on evaluation of the risk factors for death in a large study cohort.

Methods: The patient population included 359 subjects undergoing atrioventricular junction ablation and pacemaker insertion. Fourteen clinical and 9 ablation variables were collected at baseline. During a mean following-up of 40.8±25.6 months, 46 patients died. Survival probability was estimated by the Kaplan-Meier methods. Multivariate Cox proportional hazards regression analysis was applied to define predictors of death.

Results: Mean age was 64.6±10.6 years with 203 male (57.7%). Actuarial survival probability for the total patients was 0.953 and 0.827 at 1 and 5 year. Four clinical variables, but no ablation variables, were found to be independent predictors of death: age ≥65 year (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.00–3.69), the presence of heart failure (HR, 3.83; 95% CI, 1.87–7.86), coexisting diabetes (HR, 2.91; 95% CI, 1.47–5.77), and the value of fractional shortening ≤20% (HR, 5.79, 95% CI, 3.00–11.18). There were 20 deaths in 28 patients with ≥3 risk factors and 4 deaths in 115 patients with no risk factor.

Conclusion: The risk of death in patients undergoing ablation and pacing can be identified by readily available clinical variables. Patients with multiple risk factors are associated with an increasing mortality.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada

    John A. Yeung-Lai-Wah, Anzhen Qi, Orhan Uzun, Karin Humphries & Charles R. Kerr

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  1. John A. Yeung-Lai-Wah
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  2. Anzhen Qi
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  3. Orhan Uzun
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  4. Karin Humphries
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  5. Charles R. Kerr
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Correspondence to John A. Yeung-Lai-Wah.

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Yeung-Lai-Wah, J.A., Qi, A., Uzun, O. et al. Long-Term Survival Following Radiofrequency Catheter Ablation of Atrioventricular Junction for Atrial Fibrillation: Clinical and Ablation Determinants of Mortality. J Interv Card Electrophysiol 6, 17–23 (2002). https://doi.org/10.1023/A:1014168021615

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