Pulmonary vein antrum isolation, atrioventricular junction ablation, and antiarrhythmic drugs combined with direct current cardioversion: Survival rates at 7 years follow-up

Kai Sonne, Dimpi Patel, Prasant Mohanty, Luciana Armaganijan, Lucie Riedlbauchova, Moataz El-Ali, Luigi Di Biase, Preeti Venkatraman, Mazen Shaheen, Marketa Kozeluhova, Robert Schweikert, J. David Burkhardt, Robert Canby, Oussama Wazni, Walid Saliba, Andrea Natale

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: To report survival rates in patients treated with pulmonary vein antrum isolation (PVAI), atrioventricular junctional ablation (AVJA), and antiarrhythmic and direct current cardioversion (A + DCCV) at 7 years follow-up. Methods: From February 2002-December 2004, 1,000 consecutive patients underwent PVAI or A + DCCV or AVJA. These patients were matched in a nested case-controlled methodology. Survival rates were compared at the end of 7 years. Results: Three hundred and forty-five consecutive patients had undergone PVAI (34.5%), 157 (15.7%) consecutive patients AVJA, and 498(49.8%) A + DCCV. After matching the patients in a nested case-controlled methodology, 146 (32.3%) patients were in the PVAI group, 205 (59.4%) in the A + DCCV, and 101 (22.3%) in the AVJA. At 69 ± 27 months, 63 (13.9%) patients had died in the matched population. Three (2.1%) patients died in the PVAI group, 34 (16.5%) in the A + DCCV group, and 26 (25.7%) in the AVJA group. In multivariable analysis, treatment strategy was a significant predictor of mortality. Compared to patients with PVAI (reference group), those with A + DCCV (HR 4.9, p = 0.011) and AVJA (HR 10.6, p = 0.001) procedures had higher mortality risk. Conclusion: Compared to the other two procedures, patients with PVAI had the best survival rates at the end of 7 years. However, the observational case-control design of this study incurs the potential for confounding due to non-randomized treatment selection, and creates a major limitation in making valid generalization of the findings.

Original languageEnglish (US)
Pages (from-to)121-126
Number of pages6
JournalJournal of Interventional Cardiac Electrophysiology
Volume26
Issue number2
DOIs
StatePublished - Nov 2009
Externally publishedYes

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Keywords

  • Antiarrhythmic drugs (AADs)
  • Atrial fibrillation (AF)
  • Atrioventricular junction ablation (AVJA)
  • Catheter ablation
  • Direct current cardioversion (DCCV)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Sonne, K., Patel, D., Mohanty, P., Armaganijan, L., Riedlbauchova, L., El-Ali, M., Di Biase, L., Venkatraman, P., Shaheen, M., Kozeluhova, M., Schweikert, R., Burkhardt, J. D., Canby, R., Wazni, O., Saliba, W., & Natale, A. (2009). Pulmonary vein antrum isolation, atrioventricular junction ablation, and antiarrhythmic drugs combined with direct current cardioversion: Survival rates at 7 years follow-up. Journal of Interventional Cardiac Electrophysiology, 26(2), 121-126. https://doi.org/10.1007/s10840-009-9436-1