This article presents the findings of the 2012 Spanish Catheter Ablation Registry.
Data were collected in 2 ways: retrospectively using a standardized questionnaire, and prospectively using a central ...database. Each participating center selected its own preferred method of data collection.
Seventy-four Spanish centers voluntarily contributed data to the survey. A total of 11 042 ablation procedures were analyzed, averaging 149 (103) per center. The 3 main conditions treated were atrioventricular nodal reentrant tachycardia (n=2842; 25.7%), cavotricuspid isthmus (n=2485; 23%), and accessory pathways (n=1999; 18%). Atrial fibrillation was the fourth most common substrate treated (n=1852; 17%), representing a slight increase. The number of ventricular arrhythmia ablation procedures was similar to that of 2011, but there was a decrease in procedures for ventricular tachycardia associated with postinfarction scarring. The overall success rate was 94.9%, major complications occurred in 1.9%, and the overall mortality rate was 0.04%.
Data from the 2012 registry show that the number of ablations performed continued to increase. Overall, they also show a high success rate and a low number of complications. Ablation of complex substrates continued to increase, particularly in the case of atrial fibrillation.
Se detallan los resultados del Registro Nacional de Ablación del año 2012.
La recogida de datos se llevó a cabo mediante dos sistemas. De manera retrospectiva con la cumplimentación de un formulario y de manera prospectiva a través de una base de datos común. La elección de una u otra fue voluntaria para cada uno de los centros.
Se recogieron datos de 74 centros. El número total de procedimientos de ablación fue 11.042, con una media de 149±103 procedimientos. Los tres sustratos abordados con más frecuencia fueron la taquicardia intranodular (n=2.842; 25,7%), la ablación del istmo cavotricuspídeo (n=2.485; 23%) y las vías accesorias (n=1.999; 18%). El cuarto sustrato fue la ablación de fibrilación auricular (n=1.852; 17%), que mostró un incremento del 21% con respecto a los datos de 2011. La ablación de arritmias ventriculares ha permanecido estable, pero han disminuido los procedimientos sobre las asociadas a cicatriz tras infarto. La tasa total de éxito fue del 94,9%; la de complicaciones mayores, del 1,9% y la de mortalidad, del 0,04%.
El registro del año 2012 mantiene una línea de continuidad ascendente en el número de ablaciones realizadas y muestran, en líneas generales, una elevada tasa de éxito y bajo número de complicaciones. Continúa el aumento del abordaje de sustratos más complejos, especialmente de la fibrilación auricular.
HeartLogic is a multiparametric algorithm incorporated into implantable cardioverter-defibrillators (ICD). The associated alerts predict impending heart failure (HF) decompensations. Our objective ...was to analyze the association between alerts and clinical events and to describe the implementation of a protocol for remote management in a multicenter registry.
We evaluated study phase 1 (the investigators were blinded to the alert state) and phases 2 and 3 (after HeartLogic activation, managed as per local practice and with a standardized protocol, respectively).
We included 288 patients from 15 centers. In phase 1, the median observation period was 10 months and there were 73 alerts (0.72 alerts/patient-y), with 8 hospitalizations and 2 emergency room admissions for HF (0.10 events/patient-y). There were no HF hospitalizations outside the alert period. In the active phases, the median follow-up was 16 (95%CI, 15-22) months and there were 277 alerts (0.89 alerts/patient-y); 33 were associated with HF hospitalizations or HF death (n=6), 46 with minor decompensations, and 78 with other events. The unexplained alert rate was 0.39 alerts/patient-y. Outside the alert state, there was only 1 HF hospitalization and 1 minor HF decompensation. Most alerts (82% in phase 2 and 81% in phase 3; P=.861) were remotely managed. The median NT-proBNP value was higher within than outside the alert state (7378 vs 1210 pg/mL; P <.001).
The HeartLogic index was frequently associated with HF-related events and other clinically relevant situations, with a low rate of unexplained events. A standardized protocol allowed alerts to be safely and remotely detected and appropriate action to be taken on them.
HeartLogic es un algoritmo multiparamétrico incorporado a desfibriladores automáticos implantables (DAI). La alerta asociada predice descompensaciones de insuficiencia cardiaca (IC). Nuestro objetivo es analizar la asociación entre alertas y eventos clínicos bajo un protocolo de seguimiento común en un registro multicéntrico.
Se evaluaron la fase 1 (investigadores ciegos al estado de la alerta) y las fases 2 y 3 (tras la activación de HeartLogic, según práctica local y un protocolo común respectivamente).
Se incluyó a 288 pacientes en 15 centros. En fase 1, tras una media de observación de 10 meses, hubo 73 alertas (0,72 alertas/paciente-año), con 8 hospitalizaciones y 2 visitas a urgencias por IC (0,10 eventos/año-paciente). No hubo hospitalizaciones fuera del periodo de alerta. Las fases activas tuvieron una media de seguimiento de 16 (IC95%, 15-22) meses, con 277 alertas (0,89 alertas/año-paciente); 33 se asociaron con hospitalizaciones o muerte por IC, 46 con descompensaciones menores y 78 con otros eventos. La tasa de alertas inexplicables fue 0,39/año-paciente. Fuera del estado de alerta solo hubo una hospitalización y una descompensación menor. La mayoría de las alertas (el 82% en fase 2 y el 81% en fase 3; p=0,861) se gestionaron a distancia. La mediana de NT-proBNP fue superior en estado de alerta que fuera de él (7.378 frente a 1.210 pg/ml; p <0,001).
El índice HeartLogic se asoció con descompensaciones de IC y otros eventos relevantes, con baja tasa de alertas inexplicables. Un protocolo estandarizado permitió detectar y actuar a distancia con seguridad sobre las alertas.
The findings of the 2011 Spanish Catheter Ablation Registry are presented.
Data were collected in two ways: retrospectively using a standardized questionnaire, and prospectively from a central ...database. Each participating center selected its own preferred method of data collection.
Sixty-six Spanish centers voluntarily contributed data to the survey. Some 9662 ablation procedures were analyzed, averaging 146 (104) per center. The three main conditions treated were atrioventricular nodal reentrant tachycardia (n=2537; 26%), typical atrial flutter (n=2205; 23%) and accessory pathways (n=1813; 19%). Atrial fibrillation was the fourth most common substrate treated (n=1535; 16%) and showed a slight increase over figures for 2010. Ventricular arrhythmia ablation has increased considerably. The overall success rate was 94%; major complications occurred in 2.2% and overall mortality was 0.04%.
Data from the 2011 registry show a continued increase in the number of ablations performed with a generally high success rate and few complications. The use of complex substrate ablation continues to grow.
Se detallan los resultados del Registro Español de Ablación con Catéter del año 2011.
La recogida de datos se llevó a cabo mediante dos sistemas: retrospectivo, con la cumplimentación de un formulario, y prospectivo, a través de una base de datos común. Cada centro participante escogió su método de preferencia.
Se recogieron datos de 66 centros. El número total de procedimientos de ablación fue de 9.662, con una media de 146 ± 104 procedimientos. Los tres sustratos abordados con más frecuencia fueron la taquicardia intranodal (n = 2.537; 26%), la ablación del istmo cavotricuspídeo (n = 2.205; 23%) y las vías accesorias (n = 1.813; 19%). El cuarto sustrato fue la ablación de fibrilación auricular (n = 1.535; 16%), que mostró un incremento del 17% con respecto al registro de 2010. La ablación de arritmias ventriculares también se ha incrementado en un porcentaje considerable. La tasa total de éxito fue del 94%; la de complicaciones mayores, del 2,2% y la de mortalidad, del 0,04%.
En el registro de 2011 se mantiene una línea de continuidad ascendente en el número de ablaciones realizadas, que muestran, en líneas generales, una elevada tasa de éxito y bajo número de complicaciones. Continúa el aumento del abordaje de sustratos más complejos.
The findings of the 2010 Spanish Catheter Ablation Registry are presented.
Data were collected in two ways: retrospectively using a standardized questionnaire, and prospectively from a central ...database. Each participating center selected its own preferred method of data collection.
Fifty-seven Spanish centers voluntarily contributed data to the survey. A total of 8762 ablation procedures was analyzed, averaging 154 (97) per center. The 3 main conditions treated were atrioventricular nodal reentrant tachycardia (n=2321; 27%), typical atrial flutter (n=1839; 22%), and accessory pathways (n=1738; 20%). Atrial fibrillation was the fourth most common condition treated (n=1309; 15%), and reflects mild growth. The overall success rate was 94%, major complications occurred in 1.7%, and the overall mortality rate was 0.06%.
Data from the 2010 registry show that the number of ablations carried out continued to increase and exceeded 8700 ablations for the second time. In addition, they show, in general, a higher success rate and a lower number of complications. Again, cavotricuspid isthmus ablation for typical atrial flutter was the second most common condition treated. The number of catheter ablations carried out for ventricular arrhythmias in Spain is growing compared to the previous year.
Se detallan los resultados del Registro Nacional de Ablación del año 2010.
La recogida de datos se llevó a cabo mediante dos sistemas: de forma retrospectiva con la cumplimentación de un cuestionario y de forma prospectiva a través de una base de datos común. La elección de una u otra fue voluntaria para cada uno de los centros.
Se recogieron datos de 57 centros. El número total de procedimientos de ablación fue 8.762, con una media de 154
±
97 procedimientos. Los tres sustratos abordados con más frecuencia fueron la taquicardia intranodal (n
=
2.321; 27%), la ablación del istmo cavotricuspídeo (n
=
1.839; 22%) y las vías accesorias (n
=
1.738; 20%). El cuarto sustrato (n
=
1.309; 15%) fue la ablación de fibrilación auricular, que mostró un incremento del 10% con respecto al registro del año 2009. La tasa total de éxito fue del 94%; la de complicaciones mayores, del 1,7% y la de mortalidad, del 0,06%.
En el registro del año 2010 se mantiene una línea de continuidad ascendente en el número de ablaciones realizadas, que superan por segunda vez los 8.700 procedimientos y muestran, en líneas generales, una elevada tasa de éxito y bajo número de complicaciones. La ablación del istmo cavotricuspídeo, como tratamiento del aleteo auricular típico, continúa siendo el segundo sustrato más frecuentemente abordado. Se observa un mayor incremento en el número de procedimientos de ablación de arritmias ventriculares respecto a años anteriores.
This article reports the findings of the 2009 Spanish national Catheter Ablation Registry.
Data were collected in two ways: retrospectively using a standard questionnaire and prospectively from a ...central database. Each center chose its own preferred method of data collection.
Data were collected from 59 centers. The total number of ablation procedures carried out was 8546, giving a mean of 145 ± 101 procedures per center. The three most frequently treated conditions were atrioventricular nodal reentrant tachycardia (n = 2341; 27%), typical atrial flutter (n = 1859; 21.7%) and accessory pathways (n = 1758; 20.5%). The fourth most common condition was atrial fibrillation (n = 1188; 14%), the number of which has grown by 44% since the 2008 registry. The overall success rate was 93%, major complications occurred in 1.9%, and the mortality rate was 0.046%.
Data from the 2009 registry show that the number of ablations carried out continued to increase and exceeded 8000 for the first time. In addition, they show, in general, a higher success rate and a lower number of complications. Cavotricuspid isthmus ablation, as treatment for typical atrial flutter, continued to be the second most common procedure. There was a substantial increase in the number of catheter ablations performed for atrial fibrillation compared with previous years.
Ventricular Perforation and Active Fixation Leads: New Entity? Rodríguez-Mañero, Moisés; Bastarrika Alemán, Gorka; Macías Gallego, Alfonso
Revista española de cardiología (English ed.),
September 2012, 2012-Sep, 2012-09-00, 20120901, Letnik:
65, Številka:
9
Journal Article
The findings of the 2006 Spanish Catheter Ablation Registry compiled by the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias are presented.
As in previous years, data ...were collected in two ways: retrospectively using a standardized questionnaire sent to electrophysiology laboratories by the Working Group on Electrophysiology and Arrhythmias, and prospectively from a central database. Each participating center selected its own preferred method of data collection.
Forty-eight Spanish centers contributed data voluntarily. A total of 6568 ablation procedures were recorded, averaging 139+/-75 per center. As in previous reports, the three most frequently treated conditions were atrioventricular nodal reentrant tachycardia (n=1881, 28%), accessory pathways (n=1628, 25%), and typical atrial flutter (n=1507, 23%). Atrial fibrillation was the fourth most common condition treated (n=540, 8%). The overall success rate was 92.2%, major complications occurred in 1.4%, and the mortality rate was 0.015%.
In 2006, the number of ablation procedures recorded in the Spanish Catheter Ablation Registry continued to grow, with more than 6500 procedures now being registered. The success rate increased and there were fewer complications. Atrial fibrillation remains the fourth most common condition treated by catheter ablation at Spanish arrhythmia units.
This article reports the findings of the 2007 Spanish Catheter Ablation Registry, as compiled by the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias.
As in previous ...years, data were collected in two ways: retrospectively using a standard questionnaire sent to electrophysiology laboratories by the Working Group on Electrophysiology and Arrhythmias, and prospectively from a central database. Each participating center selected its own preferred method of data collection.
Fifty Spanish centers contributed data voluntarily. In total, 7062 ablations were analyzed, averaging 141 (82) per center. The three most frequently treated conditions were atrioventricular nodal reentrant tachycardia (n=2068, 30%), typical atrial flutter (n=1701, 24%) and accessory pathways (n=1624, 23%). A steady increase in both the absolute number of cavotricuspid isthmus ablations for typical atrial flutter and in the relative frequency of this procedure was observed, such that it has overtaken accessory pathway ablation to became the second most common form of treatment. The fourth most common condition was atrial fibrillation (n=659, 9%), which accounted for 22% more procedures than in 2006. Overall, the success rate was 92%, major complications occurred in 1.7%, and the mortality rate was 0.04%.
Registry data for 2007 show that the number of ablations carried out continues to increase, and has exceeded 7000 for the first time. In general, the success rate was high and there were few complications. Typical atrial flutter, requiring cavotricuspid isthmus ablation, has become the second most frequently treated condition. A moderate steady increase in the number of ablations for atrial fibrillation was also observed.
HeartLogic es un algoritmo multiparamétrico incorporado a desfibriladores automáticos implantables (DAI). La alerta asociada predice descompensaciones de insuficiencia cardiaca (IC). Nuestro objetivo ...es analizar la asociación entre alertas y eventos clínicos bajo un protocolo de seguimiento común en un registro multicéntrico.
Se evaluaron la fase 1 (investigadores ciegos al estado de la alerta) y las fases 2 y 3 (tras la activación de HeartLogic, según práctica local y un protocolo común respectivamente).
Se incluyó a 288 pacientes en 15 centros. En fase 1, tras una media de observación de 10 meses, hubo 73 alertas (0,72 alertas/paciente-año), con 8 hospitalizaciones y 2 visitas a urgencias por IC (0,10 eventos/año-paciente). No hubo hospitalizaciones fuera del periodo de alerta. Las fases activas tuvieron una media de seguimiento de 16 (IC95%, 15-22) meses, con 277 alertas (0,89 alertas/año-paciente); 33 se asociaron con hospitalizaciones o muerte por IC, 46 con descompensaciones menores y 78 con otros eventos. La tasa de alertas inexplicables fue 0,39/año-paciente. Fuera del estado de alerta solo hubo una hospitalización y una descompensación menor. La mayoría de las alertas (el 82% en fase 2 y el 81% en fase 3; p=0,861) se gestionaron a distancia. La mediana de NT-proBNP fue superior en estado de alerta que fuera de él (7.378 frente a 1.210 pg/ml; p <0,001).
El índice HeartLogic se asoció con descompensaciones de IC y otros eventos relevantes, con baja tasa de alertas inexplicables. Un protocolo estandarizado permitió detectar y actuar a distancia con seguridad sobre las alertas.
HeartLogic is a multiparametric algorithm incorporated into implantable cardioverter-defibrillators (ICD). The associated alerts predict impending heart failure (HF) decompensations. Our objective was to analyze the association between alerts and clinical events and to describe the implementation of a protocol for remote management in a multicenter registry.
We evaluated study phase 1 (the investigators were blinded to the alert state) and phases 2 and 3 (after HeartLogic activation, managed as per local practice and with a standardized protocol, respectively).
We included 288 patients from 15 centers. In phase 1, the median observation period was 10 months and there were 73 alerts (0.72 alerts/patient-y), with 8 hospitalizations and 2 emergency room admissions for HF (0.10 events/patient-y). There were no HF hospitalizations outside the alert period. In the active phases, the median follow-up was 16 (95%CI, 15-22) months and there were 277 alerts (0.89 alerts/patient-y); 33 were associated with HF hospitalizations or HF death (n=6), 46 with minor decompensations, and 78 with other events. The unexplained alert rate was 0.39 alerts/patient-y. Outside the alert state, there was only 1 HF hospitalization and 1 minor HF decompensation. Most alerts (82% in phase 2 and 81% in phase 3; P=.861) were remotely managed. The median NT-proBNP value was higher within than outside the alert state (7378 vs 1210 pg/mL; P <.001).
The HeartLogic index was frequently associated with HF-related events and other clinically relevant situations, with a low rate of unexplained events. A standardized protocol allowed alerts to be safely and remotely detected and appropriate action to be taken on them.
Full English text available from:www.revespcardiol.org/en
