Int J Arrhythm.  2018 Mar;19(1):14-21. 10.18501/arrhythmia.2018.002.

Efficacy and Safety Outcomes of Catheter Ablation of Non-valvular Atrial Fibrillation in Korean Practice: Analysis of Nationwide Claims Data

Affiliations
  • 1Health Insurance Review and Assessment Service, Seoul, Korea.
  • 2Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. sungwon.jang@catholic.ac.kr

Abstract

BACKGROUND AND OBJECTIVES
The aim of this study was to investigate the effectiveness and selected adverse events of radiofrequency catheter ablation in patients treated for drug-refractory atrial fibrillation (AF) using claims data provided by the Health Insurance Review and Assessment Service, which covers all ablation procedures conducted in South Korea.
SUBJECTS AND METHODS
The study population included patients who underwent catheter ablation for AF between January 2011 and December 2013. A total of 3,850 patients without a previous history of catheter ablation procedure were enrolled. We analyzed 2-year effectiveness of the index ablation. Any redo ablation, electrical cardioversion, or use of antiarrhythmic drug beyond the blanking period of 3 months was considered a failure of index ablation.
RESULTS
Overall recurrence rate following AF ablation was 61.1%. The recurrence rate was lower in patients under 65 years old than in those over 65 years old (hazard ratio [HR] 0.89; 95% confidence interval [CI], 0.81 to 0.97, P=0.009). Repeat ablation was more frequent in men (HR 1.56; 95% CI, 1.20 to 2.04; P=0.001) and patients under 65 years old (HR 1.79; 95% CI, 1.34 to 2.38; P < 0.001). Electric cardioversion was more frequent in men (HR 1.35; 95% CI, 1.06 to 1.72; P=0.014) than in women. The overall rate of stroke, blood transfusion, significant pericardial complication, and cardiopulmonary resuscitation was 0.5%, 4.8%, 2.7%, and 0.2%, respectively.
CONCLUSIONS
In the present study, old age was associated with treatment failure of catheter ablation for drug-refractory AF in the Korean population. Overall recurrence did not vary with respect to sex.

Keyword

Atrial Fibrillation; Catheter Ablation; Recurrence; Pericardiocentesis; Hemorrhage; Blood Transfusion; Stroke

MeSH Terms

Atrial Fibrillation*
Blood Transfusion
Cardiopulmonary Resuscitation
Catheter Ablation*
Catheters*
Electric Countershock
Female
Hemorrhage
Humans
Insurance, Health
Korea
Male
Pericardiocentesis
Recurrence
Stroke
Treatment Failure
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