Digitalis therapy is associated with higher comorbidities and poorer prognosis in patients undergoing ablation of atrial arrhythmias: data from the German Ablation Registry
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Digitalis therapy is associated with higher comorbidities and poorer prognosis in patients undergoing ablation of atrial arrhythmias: data from the German Ablation Registry. / Frommeyer, Gerrit; Brachmann, Johannes; Ince, Hüseyin; Spitzer, Stefan G; Thomas, Dierk; Willems, Stephan; Schumacher, Burghard; Schirdewahn, Petra; Lewalter, Thorsten; Hochadel, Matthias; Senges, Jochen; Eckardt, Lars.
in: CLIN RES CARDIOL, Jahrgang 108, Nr. 10, 10.2019, S. 1083-1092.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Digitalis therapy is associated with higher comorbidities and poorer prognosis in patients undergoing ablation of atrial arrhythmias: data from the German Ablation Registry
AU - Frommeyer, Gerrit
AU - Brachmann, Johannes
AU - Ince, Hüseyin
AU - Spitzer, Stefan G
AU - Thomas, Dierk
AU - Willems, Stephan
AU - Schumacher, Burghard
AU - Schirdewahn, Petra
AU - Lewalter, Thorsten
AU - Hochadel, Matthias
AU - Senges, Jochen
AU - Eckardt, Lars
PY - 2019/10
Y1 - 2019/10
N2 - BACKGROUND: Digitalis glycosides are employed for rate control of atrial fibrillation. Recent studies suggested potential harmful effects of digitalis monotherapy and combination with antiarrhythmic drugs. The aim of the present study was to assess the prevalence and potential impact of digitalis therapy on outcome in patients undergoing catheter ablation of supraventricular arrhythmias.METHODS AND RESULTS: The German Ablation Registry is a nationwide, prospective registry with a 1-year follow-up investigating 12,566 patients receiving catheter ablations of supraventricular arrhythmias in 52 German centres. The present analysis focussed on pharmacotherapy in 8608 patients undergoing catheter ablation of atrial tachycardia, atrial fibrillation, or atrial flutter. Patients receiving digitalis therapy (n = 417) were older and presented a significantly increased prevalence of comorbidities including coronary artery disease, heart failure, diabetes, and pulmonary disease. One-year mortality was significantly higher in digitalis-treated patients (4.7% vs. 1.3%, p < 0.001), most strikingly in patients undergoing ablation of atrial flutter. This effect was maintained after adjustment for important risk factors. Similar results were obtained for as the combined endpoint of death, myocardial infarction, stroke and major bleeding (6.6% vs. 2.7%, p < 0.001), and non-fatal rehospitalisations (54.1% vs. 45.1%, p = 0.001).CONCLUSION: In the present study of patients undergoing catheter ablation of supraventricular arrhythmias, an association of digitalis therapy with increased mortality and an increased rate of other severe adverse events were observed. The results from this 'real-life' registry are consistent with previously published studies. However, whether digitalis therapy promotes a poorer prognosis or may just serve as a marker for this aspect cannot be thoroughly interpreted.
AB - BACKGROUND: Digitalis glycosides are employed for rate control of atrial fibrillation. Recent studies suggested potential harmful effects of digitalis monotherapy and combination with antiarrhythmic drugs. The aim of the present study was to assess the prevalence and potential impact of digitalis therapy on outcome in patients undergoing catheter ablation of supraventricular arrhythmias.METHODS AND RESULTS: The German Ablation Registry is a nationwide, prospective registry with a 1-year follow-up investigating 12,566 patients receiving catheter ablations of supraventricular arrhythmias in 52 German centres. The present analysis focussed on pharmacotherapy in 8608 patients undergoing catheter ablation of atrial tachycardia, atrial fibrillation, or atrial flutter. Patients receiving digitalis therapy (n = 417) were older and presented a significantly increased prevalence of comorbidities including coronary artery disease, heart failure, diabetes, and pulmonary disease. One-year mortality was significantly higher in digitalis-treated patients (4.7% vs. 1.3%, p < 0.001), most strikingly in patients undergoing ablation of atrial flutter. This effect was maintained after adjustment for important risk factors. Similar results were obtained for as the combined endpoint of death, myocardial infarction, stroke and major bleeding (6.6% vs. 2.7%, p < 0.001), and non-fatal rehospitalisations (54.1% vs. 45.1%, p = 0.001).CONCLUSION: In the present study of patients undergoing catheter ablation of supraventricular arrhythmias, an association of digitalis therapy with increased mortality and an increased rate of other severe adverse events were observed. The results from this 'real-life' registry are consistent with previously published studies. However, whether digitalis therapy promotes a poorer prognosis or may just serve as a marker for this aspect cannot be thoroughly interpreted.
KW - Aged
KW - Anti-Arrhythmia Agents/therapeutic use
KW - Atrial Fibrillation/epidemiology
KW - Atrial Flutter/epidemiology
KW - Catheter Ablation/methods
KW - Comorbidity
KW - Digitalis Glycosides/therapeutic use
KW - Female
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prognosis
KW - Prospective Studies
KW - Recurrence
KW - Registries
KW - Tachycardia, Supraventricular/epidemiology
U2 - 10.1007/s00392-019-01442-w
DO - 10.1007/s00392-019-01442-w
M3 - SCORING: Journal article
C2 - 30798346
VL - 108
SP - 1083
EP - 1092
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 10
ER -
