Resultadosįoram submetidos 123 doentes à ANAV: idade média 69 ± 9 anos e 52% homens. MétodosĪnálise retrospetiva detalhada, dos doentes submetidos à ANAV entre fevereiro 1997 e fevereiro 2019, num centro terciário português. ObjetivosĪvaliar os resultados em longo prazo após a ANAV e analisar preditores de eventos adversos. Nos doentes com disritmias supraventriculares e frequência ventricular elevada, irresponsivos à terapêutica para controlo da frequência e do ritmo, ou à ablação por catéter, a ablação do nódulo auriculoventricular (ANAV) pode ser realizada. AV node ablation should probably be considered earlier in the treatment of patients with supraventricular arrhythmias and HF, especially in cases that are unsuitable for selective ablation of the specific arrhythmia. The number of ED visits due to HF before AV node ablation was an independent predictor of the composite adverse outcome. Conclusionsĭespite pacemaker dependency, the clinical benefit of AV node ablation persisted at long-term follow-up. The number of ED visits due to HF before AV node ablation was an independent predictor of the composite adverse outcome (OR 1.8, 95% CI 1.24-2.61, p=0.002). Despite permanent pacemaker stimulation, left ventricular ejection fraction did not worsen (47☑3% vs. There were no device-related complications. During a median follow-up of 8.5 years (interquartile range 3.8-11.8), patients improved heart failure (HF)įunctional class (NYHA class III-IV 46% versus 13%, p=0.001), and there were reductions in hospitalizations due to HF (0.98☑.3 versus 0.28☐.8, p=0.001) and emergency department (ED) visits (1.1☑ versus 0.17☐.7, p=0.0001). Most of them presented atrial fibrillation at baseline (65%). ResultsĪ total of 123 patients, mean age 69☙ years and 52% male, underwent AV node ablation. We performed a detailed retrospective analysis of all patients who underwent AV node ablation between February 1997 and February 2019, in a single Portuguese tertiary center. To assess long-term outcomes after AV node ablation and to analyze predictors of adverse events. Out of 100 people enrolled, 96 completed the study (mean age 59, 32% women) after being randomized to usual medical therapy or catheter ablation with encouragement of uninterrupted oral anticoagulation.Īll 49 participants in the ablation arm had successful pulmonary vein isolation of those, one in five received additional ablation.In patients with supraventricular arrhythmias and high ventricular rate, unresponsive to rate and rhythm control therapy or catheter ablation, atrioventricular (AV) node ablation may be performed.
Ra ablation for atrial flutter icd 10 pcs trial#
The investigators conducted their randomized trial at two tertiary hospitals in Australia, enrolling individuals with symptomatic paroxysmal or persistent Afib who failed at least one antiarrhythmic drug (AAD). Kalman and colleagues themselves lacked preablation and postablation MRI scans to assess any relationship between cognitive outcomes and silent cerebral embolic lesions. They nevertheless cited a recent study showing silent brain embolic events commonly found on cardiac MRI have no bearing on cognitive function deterioration, which suggests that POCD is not solely caused by these imaging findings. "The etiology of POCD following catheter ablation is multifactorial and remains incompletely explained," study authors noted. Separately, it is thought that postablation cognitive dysfunction may be caused by anesthesia or silent cerebral embolic lesions stemming from procedure. Kalman and colleagues reported that ablation time was the only significant multivariable predictor of new-onset cognitive dysfunction (OR 1.30, 95% CI 1.01-1.60).Īfib has been linked to long-term cognitive and memory problems independent of stroke, with multifactorial factors including silent cerebral infarction, cerebral hypoperfusion, and microbleeds. "We believe this data provides reassurance regarding the impact of catheter ablation on cognitive function." However, this was transient with complete recovery at 12-month follow-up," Kalman's group concluded.
"POCD was observed following AF ablation.
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