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Reduction in shock burden with catheter ablation versus escalated antiarrhythmic drug therapy: Insights from the VANISH trial. Europace 2022. [DOI: 10.1093/europace/euac053.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): 1. Canadian Institutes of Health Research (CIHR)
2. Additional financial support from St. Jude Medical and Biosense Webster
Background
Recurrent shocks for ventricular tachycardia (VT) are associated with an increased risk of heart failure and mortality and have a negative influence on quality of life. Catheter ablation has been shown to improve VT event-free survival in patients with antiarrhythmic drug (AAD)-refractory VT and prior myocardial infarction (MI); however, the effects of ablation on shock burden has yet to be investigated.
Purpose
Our primary objectives were to compare the shock-treated VT event burden and appropriate shock burden following randomization to treatment with either catheter ablation or escalated AAD therapy among VT patients with prior MI in the Ventricular tachycardia AblatioN versus escalated antiarrhythmic drug therapy in Ischemic Heart disease (VANISH) randomized trial.
Methods
Recurrent event analyses were performed using the intention-to-treat population of the VANISH trial. Shock-treated VT event burden was defined as the total number of VT events treated with ≥1 appropriate internal or external shocks. Appropriate shock burden was defined as the total number of appropriate internal and external shocks delivered, regardless of the number of VT events. All VT events and implantable cardioverter defibrillator (ICD) therapies were adjudicated by reviewers blinded to the treatment allocation. Three recurrent event models were used to compare the shock burden between treatment arms (Anderson-Gill (AG), Frailty, and Prentice, Williams, and Peterson Total Time (PWP-TT). Each model clustered by patient and accounted for competing risk of death with the Fine and Gray sub-distributions hazards model.
Results
Of the 259 patients enrolled in the VANISH trial [median age 69.8 (IQR 63.0-74.2) years, 7.0% women], 132 patients were randomized to ablation and 129 patients to escalated AAD therapy. Over a median follow-up of 23.4 (IQR 14.7-40.4) months, there were 138 shock-treated VT events [39.07 (95% CI 33.14-46.07) shock-treated VT events per 100 person-years] in the ablation arm and 218 shock-treated VT events [64.60 (95% CI 56.49–73.84) shock-treated VT events per 100 person-years] in the escalated AAD therapy arm (Figure 1). Ablation patients had a 40% lower shock-treated VT event burden (ie. number of shock-treated VT events) compared to patients randomized to escalated AAD therapy [Figure 1; AG HR 0.60 (95% 0.38-0.95)]. Further, there was also a statistically significant reduction in the appropriate shock burden (i.e. number of appropriate shocks) among ablation patients (169 appropriate shocks) compared to escalated AAD therapy patients (266 appropriate shocks) [Figure 1; AG HR 0.61 (95% CI 0.37-0.96)]. All results were consistent between the 3 recurrent event models.
Conclusion
Among patients with AAD-refractory VT and a prior MI, catheter ablation reduced shock-treated VT event burden and appropriate shock burden compared to escalated AAD therapy.
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Comparative effectiveness of ventricular tachycardia ablation versus escalated antiarrhythmic drug therapy by location of myocardial infarction: A sub-study of the VANISH trial. Europace 2021. [DOI: 10.1093/europace/euab116.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Fonds de recherché du Québec-Santé (FRQS) [post doctoral award for Dr. Samuel)
BACKGROUND
Complexity of ventricular tachycardia (VT) substrate, efficiency of lesion formation, and the size and thickness of infarction area border zones differ based on location of myocardial infarctions (MI). These differences may translate into heterogeneity in risk of events and effectiveness of treatments for VT. Small observational studies suggest that VT from inferior infarctions have higher risk of early recurrence despite smaller infarct areas. However, differential effectiveness of VT treatments based on location of MI not been definitively established.
PURPOSE
The objective of this sub-study of the Ventricular tachycardia AblatioN versus escalated antiarrhythmic drug therapy in ISchemic Heart disease (VANISH) randomized trial was to compare the effectiveness of VT ablation by location of MI in reducing the composite endpoint of all-cause mortality, VT storm, or appropriate ICD therapy when compared to escalated pharmacological therapy in VT patients with a prior MI.
METHODS
VANISH participants were categorized into 3 subgroups based on MI location: 1. Inferior (may also have MI in other locations); 2. Non-inferior (no inferior MI, all patients not in group 1); and 3. Anterior (may also have MI in other locations). Inverse probability of treatment weighting was used to balance baseline characteristics (ie. age, sex, comorbidities, medications, and the location of additional infarctions) between patients randomized to ablation or escalated therapy within each subgroup. Weighted Cox proportional hazards models were calculated separately for each subgroup.
RESULTS
Of 259 patients enrolled in the VANISH trial [median age 69.8 (IQR 63.0-74.2) years, 7.0% women], 135 had an inferior MI, 124 a non-inferior MI, and 83 an anterior MI. Among patients with an inferior MI, no statistically significant difference in the primary outcome was detected between patients randomized to ablation or escalated therapy [aHR 0.78 (95% CI 0.51-1.20)]. In contrast, patients with non-inferior MIs had a statistically significant reduction in the incidence of the primary outcome with ablation [aHR 0.48 (95% CI 0.27-0.86)]; which was of greater magnitude than the reduction observed in the overall results of the VANISH trial [HR 0.72 (95% CI 0.53-0.98)]. In addition, a trend towards a reduction in the primary outcome with ablation was detected in patients with anterior MIs [aHR 0.50 (95% CI 0.23-1.09)].
CONCLUSION
The effectiveness of VT ablation versus escalated pharmacological therapy varies based on the location of the MI. Patients with MI scars located only in non-inferior regions of the ventricles derive greater benefit from VT ablation in reducing VT-related events. Further studies are required to explore reasons for this finding and to assess the impact of VT treatment strategies based on MI location in optimizing outcomes.
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P1024Catheter ablation is associated with reduced all-cause mortality in a real-world cohort of patients with atrial fibrillation and heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) and heart failure (HF) are common co-existing conditions. Randomized trial data suggests a reduction in all-cause mortality with catheter ablation (CA) in selected patients, however, whether these results are replicable in a real-world population and persist in the long-term remains to be shown.
Purpose
To evaluate the long-term effectiveness of CA in AF-HF patients in reducing the incidence of: a) all-cause mortality b) HF hospitalizations, and c) major morbidities (stroke/transient ischemic attack (TIA) and major bleeding).
Methods
A population-based administrative cohort was created of AF-HF patients with government prescription coverage in Quebec, Canada (1999–2015). Patients who underwent CA (cases) were matched 1:2 to controls using risk-set sampling. Cases were matched on time in the cohort and frequency of hospitalizations. Measured time-invariant confounders were controlled for using inverse probability of treatment weighting (IPTW) and included age, sex, clinical characteristics, presence of cardiac implantable electronic devices, and medication use. Multivariable Cox models adjusted the association of CA with the outcomes for the time varying confounders of the presence of an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT), anticoagulation use (warfarin or direct oral anticoagulation), and any antiarrhythmic (AAD) use during follow-up. For non-fatal outcomes, the competing risk of death was accounted for using the Lunn-McNeil approach.
Results
Of the 87,676 AF-HF patients, 298 underwent CA and were matched to 591 controls. After IPTW, the distribution of covariates was balanced between cases and controls [age 65.6±11.0 vs 61.6±11.6; women 24% vs 20%; CHA2DS2-Vasc score 3.2±2.3 vs 2.9±2.1; CA vs non-CA, respectively; standardized mean differences <0.1 for all]. Over a median follow-up of 3.3 (IQR 1.1–6.4) years, 19 (7.3%) of CA patients died compared to 144 (24.6%) non-CA patients. After weighting and adjustment, CA was associated with a statistically significant reduction in the incidence of all-cause mortality [adjusted HR 0.5 (95% CI 0.3–0.9)]. In addition, there was no statistically significant difference in the incidence of HF hospitalizations over the follow-up [CA: 22.5% vs non-CA: 27.1%; adjusted HR 0.9 (95% CI 0.6–1.2)]. The incidences of stroke/TIA (1.7% vs 6.8%) and major bleeding (1.7% vs 4.9%) for CA vs non-CA were not statistically different.
Conclusion
In a matched population-based AF-HF cohort, CA was associated with a reduced risk of all-cause mortality compared to patients who did not undergo CA. Although no difference in the risk of HF hospitalizations, stroke/TIA, and major bleeding was detected between CA and non-CA patients, larger studies are warranted.
Acknowledgement/Funding
Canadian Institute of Health Research; Fonds de recherché du Quebec-Santé, Clinical Research Scholar Award (V. Essebag) and Doctoral Award (M. Samuel)
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IMPROVED ELECTRICAL SYNCHRONY BY CARDIAC RESYNCHRONIZATION THERAPY REPROGRAMMING AND ECHOCARDIOGRAPHIC RESPONSE IN PATIENTS WITH EXISTING DEVICES. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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CATHETER ABLATION IS ASSOCIATED WITH REDUCED ALL-CAUSE MORTALITY IN A REAL-WORLD COHORT OF PATIENTS WITH ATRIAL FIBRILLATION AND HEART FAILURE. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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THE IMPACT OF KNOWLEDGE TRANSLATION AND INTEGRATED CARDIOVASCULAR CARE ON EMERGENCY ROOM VISITS OF PATIENTS WITH ATRIAL FIBRILLATION: INSIGHTS FROM THE INTEGRATED-FACILITER PROGRAM. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS ≥75 YEARS OF AGE AND THE EFFECT OF QRS MORPHOLOGY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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8
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CATHETER ABLATION FOR ATRIAL FIBRILLATION IN HEART FAILURE WITH REDUCED EJECTION FRACTION: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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9
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CANADIAN REGISTRY OF ELECTRONIC DEVICE OUTCOMES (CREDO): THE ABBOTT BATTERY PERFORMANCE ALERT, A MULTICENTRE REGISTRY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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HEALTHCARE RESOURCE UTILIZATION IN PATIENTS WITH ATRIAL FIBRILLATION TREATED WITH CATHETER ABLATION: THE EFFECT OF RECURRENCE AND AF BURDEN. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional hazard models were used to investigate the relationship between etiology of the syncope and event-free survival. Of the 82,678 emergency visits during the study period, 160 (0.16%) patients were there due to syncope, having a previous diagnosis of structural heart disease. During the median follow-up of 33.8±13.8 months, mean age at the qualifying syncope event was 68.3 years and 40.6% of patients were male. Syncope was vasovagal in 32%, cardiogenic in 57%, orthostatic hypotension in 6%, and of unknown causes in 5% of patients. The primary composite endpoint death, readmission, and emergency visit in 30 days was 39.4% in vasovagal syncope and 60.6% cardiogenic syncope (P<0.001). Primary endpoint-free survival was lower for patients with cardiogenic syncope (HR=2.97, 95%CI=1.94-4.55; P<0.001). The scores were analyzed for diagnostic performance with area under the curve (AUC) and did not help differentiate patients with an increased risk of adverse events. The differential diagnosis of syncope causes in patients with structural heart disease is important, because vasovagal and postural hypotension have better survival and less probability of emergency room or hospital readmission. The available scores are not reliable tools for prognosis in this specific patient population.
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EFFECT OF BASELINE ANTIARRHYTHMIC DRUG ON OUTCOMES WITH ABLATION IN ISCHEMIC VENTRICULAR TACHYCARDIA: A VANISH SUBSTUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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PORTRAIT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR REPLACEMENT IN QUÉBEC: A SYSTEMATIC FIELD EVALUATION. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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SYNCOPE: PACING VERSUS RECORDING IN THE LATER YEARS. A RANDOMIZED PRAGMATIC CLINICAL TRIAL OF STRATEGIES OF PERMANENT PACEMAKER VERSUS IMPLANTABLE CARDIAC MONITOR IN OLDER PATIENTS WITH SYNCOPE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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THE IMPACT OF EMPIRICAL LEFT ATRIAL APPENDAGE ISOLATION IN ATRIAL FIBRILLATION CATHETER ABLATION: A META-ANALYSIS. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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COST EFFECTIVENESS OF VENTRICULAR TACHYCARDIA ABLATION VERSUS ESCALATION OF ANTIARRHYTHMIC DRUG THERAPY IN THE VANISH TRIAL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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PREDICTING ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY: THE USE OF STRICT LEFT BUNDLE BRANCH BLOCK CRITERIA. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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A PROSPECTIVE, MULTICENTER COHORT STUDY COMPARING PHASED MULTIPOLAR VERSUS TRADITIONAL RADIOFREQUENCY ABLATION. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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QUALITY OF LIFE IN PATIENTS WITH ABLATION OR MEDICAL THERAPY FOR VENTRICULAR ARRHYTHMIAS: A SUBSTUDY OF VANISH. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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PROGNOSTIC VALUE OF NON-INDUCIBILITY ON OUTCOMES OF VENTRICULAR TACHYCARDIA ABLATION: A VENTRICULAR TACHYCARDIA ABLATION VS. ENHANCED DRUG THERAPY IN STRUCTURAL HEART DISEASE (VANISH) SUBSTUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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1152Second generation cryoballoon ablation in paroxysmal atrial fibrillation patients: 24 month safety and efficacy from the STOP-AF post approval study. Europace 2017. [DOI: 10.1093/ehjci/eux152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P1396Incidence and significance of early AF recurrences with the second generation cryoballoon: insights from the STOP-AF post approval study. Europace 2017. [DOI: 10.1093/ehjci/eux158.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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Asymptomatic atrial fibrillation burden and thromboembolic events: piecing evidence together. Expert Rev Cardiovasc Ther 2016; 14:761-9. [DOI: 10.1586/14779072.2016.1154457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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MANAGEMENT OF PATIENTS WITH ATRIAL FIBRILLATION BY FAMILY MEDICINE GROUPS IN QUÉBEC: INSIGHTS FROM THE I-FACILITER STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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HOW WELL ARE RATE OR RHYTHM CONTROL ACHIEVED IN RAFT-AF PATIENTS WITH ATRIAL FIBRILLATION AND HEART FAILURE? Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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26
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Impact of BMI on risk of CIED pocket hematoma: a sub-analysis of the BRUISE trial. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2015; 19:3137-3138. [PMID: 26400511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Risk of pocket hematoma in patients on chronic anticoagulation with warfarin undergoing electrophysiological device implantation: a comparison of different peri-operative management strategies. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2015; 19:1461-79. [PMID: 25967723 DOI: pmid/25967723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Periprocedural management of warfarin remains challenging in patients requiring electrophysiological device surgery. For patients at high risk of thromboembolic events, guidelines recommend bridging therapy with heparin; however, this strategy is associated with a high risk of pocket hematoma. This paper systematically reviews studies appraising the risk of pocket hematoma with different perioperative anticoagulation strategies. METHODS All relevant studies identified in MEDLINE/PubMed, The Cochrane Collaboration CENTRAL, clinicaltrials.org and in bibliographies of key articles. Estimates were combined using a fixed effects model. Heterogeneity was assessed by p values of χ2 statistics and I2. Publication bias was assessed by visual examination of funnel plots and by Egger test. Fifteen studies enrolling 5911 patients met all inclusion criteria and were included in this review. RESULTS Heparin bridging compared with no heparin was associated with increased risk of pocket hematoma (OR = 4.47, 95% CI 3.21-6.23, p < 0.00001), and prolonged hospital stay (9.13 ± 1.9 days vs. 5.11 ± 1 .39 days, p < 0.00001). Warfarin continuation was not associated with increased pocket hematoma compared to warfarin discontinuation (p = 0.38), but was associated with reduced risk of pocket hematoma compared with heparin bridging (OR = 0.37, 95% CI 0.2-0.69, p = 0.002). Thromboembolic complications were reduced with heparin bridging vs. no heparin (0.50% vs.1.07%, p = 0.02), and no significant differences were reported between heparin bridging vs. warfarin continuation (p = 0.83). CONCLUSIONS Heparin bridging is associated with a higher risk of pocket hematoma and a prolonged hospital stay. Perioperative continuation of warfarin reduces the occurrence of pocket hematoma compared with heparin bridging without any significant differences in thromboembolic complications.
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Substrate-guided ablation of haemodynamically tolerated and untolerated ventricular tachycardia in patients with structural heart disease: effect of cardiomyopathy type and acute success on long-term outcome. Europace 2014; 17:461-7. [DOI: 10.1093/europace/euu326] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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EFFICACY OF ANTI-TACHYCARDIA PACING IN THE TREATMENT OF VENTRICULAR ARRHYTHMIAS IN THE RAFT TRIAL. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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RISKS OF LONG-TERM MORTALITY AND MAJOR ADVERSE CARDIAC EVENTS ASSOCIATED WITH DIABETES MELLITUS IN PATIENTS HOSPITALIZED FOR ATRIAL FIBRILLATION. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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THE RESPONSE TO ANTITACHYCARDIA PACING DIFFERENTIATES VENTRICULAR FROM SUPRAVENTRICULAR TACHYCARDIA. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Snapshot of Invasive Electrophysiology in Canada in 2012: Results From the National Survey. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Can We Predict the Occurrence of Atrial Fibrillation Following Typical Right Atrial Flutter Ablation? Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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597 Cardiac Biomarkers Levels in Patients Undergoing Permanent Pacemaker Implantation for Non-Paroxysmal Atrioventricular Block. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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766 Prevention of Arrhythmia Device Infection Trial (PADIT): Pilot Study Results. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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600 Safer Pacing Mode Significantly Prevents V Pacing as Compared to DDD With Long AV Delays or AV Delay Hysteresis. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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643 Left ventricular capture management study. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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552 Patient distress following fidelis defibrillator lead advisory. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Abstracts: Tools to facilitate ablation procedures. Europace 2009. [DOI: 10.1093/europace/euq197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Biventricular pacing for end-stage heart failure: early experience in surgical vs. transvenous left ventricular lead placement. Interact Cardiovasc Thorac Surg 2008; 7:839-44. [DOI: 10.1510/icvts.2008.178301] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Safety of long distance aeromedical transport of the cardiac patient: a retrospective study. AVIATION, SPACE, AND ENVIRONMENTAL MEDICINE 2001; 72:182-7. [PMID: 11277283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND The purpose of this study is to provide data regarding the safety of long distance air transport of cardiac patients, establish a time frame for safe transport, and assess current guidelines for postmyocardial infarct (post-MI) transport. METHODS Retrospective analysis of all long distance aeromedical transports performed by Montreal-based Skyservice Lifeguard from January 1 to October 1, 1998. RESULTS 109 cardiac patients were transported; 83 by air ambulance (AA), and 26 commercially (C). Diagnoses included MI (63%), unstable angina (31%), congestive heart failure (21%), and arrhythmia (17%). Patients were transported a mean of 7 d (AA) vs. 13.7 d (C) after presentation. Inflight complications, occurring in 10% of AA and 4% of C flights, were minor (chest pain, desaturation, and hypotension), and resolved quickly. In 51 post-MI AA patients, complication rate for transport > 7 d after admission was 0% (vs. 14% <7 d), and > 72 h after last chest pain was 6% (vs. 18% <72 h). Comparing uncomplicated (n = 25) vs. complicated (n = 26) MI reveals fewer complications for transport 0-3 d (13% vs. 50%) and 4-7 d (9% vs. 14%) after admission, and 48-72 h after last chest pain (0% vs. 100%). CONCLUSIONS AA transport of cardiac patients can safely be performed earlier than guidelines for C flights. AA transport appears safe after complicated MI by day 7 or > 72 h chest pain free, and after uncomplicated MI by day 3 or > 48 h chest pain free. Future guidelines for aeromedical transport post-MI should distinguish between C and AA.
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Essebag V, Lutchmedial S, Wolfson C, Churchill-smith M. Crit Care 2001; 5:P3. [DOI: 10.1186/cc1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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