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Effect of Electrophysiology Assessment on Mortality and Hospitalizations in Patients With New-Onset Atrial Fibrillation

机译:电生理学评估对新出现心房颤动患者死亡率和住院的影响

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Few patients with atrial fibrillation (AF) receive care by cardiac electrophysiologists. Although previous work has highlighted differential care for patients with AF treated by electrophysiologists, it is unclear whether this is associated with improved clinical outcomes. This retrospective population-level propensity score matched cohort study included patients aged 20 to 80 years with new-onset AF presenting to an emergency department (ED) in Ontario, Canada, between 2010 and 2012. Patients were followed until March 31, 2015. Patients who saw an electrophysiologist within 1 year of the index ED visit were matched to patients who did not see an electrophysiologist. Linked administrative databases were used for cohort construction and allow 1-year follow-up to assess for the clinical end points of all-cause mortality and hospitalization for AF, heart failure, bleeding, and stroke. A total of 5,221 unique pairs of patients were matched. One hundred seventeen patients (2.2%) in the electrophysiologist cohort underwent an AF ablation procedure during the 1-year follow-up period. All-cause mortality (hazard ratio [HR] = 1.1, p = 0.17) and stroke (HR = 1.4, p = 0.09) were not significantly different between the 2 groups. Hospitalization for AF (HR = 1.4, p 0.001), bleeding (HR = 1.5, p = 0.0001), and congestive heart failure (HR = 1.5, p 0.0001) was increased in the group that saw an electrophysiologist. In conclusion, electrophysiologist care was not associated with improved clinical outcomes in patients with new-onset AF. (C) 2018 Elsevier Inc. All rights reserved.
机译:少数有心房颤动(AF)的患者通过心脏电生理学家接受护理。虽然以前的工作突出了通过电生理学家治疗的AF治疗的患者的差异护理,但目前尚不清楚这是否与改善的临床结果有关。这种回顾性人口级别倾向得分匹配队列研究包括在2010年至2012年间加拿大安大略省安大略省的急诊部门(ED)的患者,于2010年至2012年间,患者持续到2015年3月31日。患者谁在1年内看到电生理学家的IDED访问与没有看到电生理学家的患者匹配。链接的行政数据库用于队列建设,并允许1年的随访,以评估全导致死亡率和住院治疗的临床终点,心力衰竭,出血和中风。共匹配总共5,221对患者。电生理学家队列中的一百十七名患者(2.2%)在1年的随访期间接受了AF消融程序。所有原因死亡率(危害比[HR] = 1.1,P = 0.17)和行程(HR = 1.4,P = 0.09)在2组之间没有显着差异。 AF的住院(HR = 1.4,P <0.001),出血(HR = 1.5,P = 0.0001),并且在看到电生理学家的基团中增加充血性心力衰竭(HR = 1.5,P <0.0001)。总之,电生理学家护理与新的新手AF的患者的改善临床结果没有相关。 (c)2018年Elsevier Inc.保留所有权利。

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