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Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis
BACKGROUND: This study aimed to describe the mid-term outcomes of different treatments in patients with atrial fibrillation caused tricuspid regurgitation. METHODS: A retrospective study of patients diagnosed as atrial fibrillation caused moderate-severe tricuspid regurgitation undergoing ablation (...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526327/ https://www.ncbi.nlm.nih.gov/pubmed/32993732 http://dx.doi.org/10.1186/s13019-020-01336-3 |
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author | Wang, Jiangang Li, Songnan Ye, Qing Ma, Xiaolong Zhao, Yichen Han, Jie Li, Yan Zheng, Shuai Liu, Kemin He, Meng Yu, Wen Sun, Junhui Meng, Xu |
author_facet | Wang, Jiangang Li, Songnan Ye, Qing Ma, Xiaolong Zhao, Yichen Han, Jie Li, Yan Zheng, Shuai Liu, Kemin He, Meng Yu, Wen Sun, Junhui Meng, Xu |
author_sort | Wang, Jiangang |
collection | PubMed |
description | BACKGROUND: This study aimed to describe the mid-term outcomes of different treatments in patients with atrial fibrillation caused tricuspid regurgitation. METHODS: A retrospective study of patients diagnosed as atrial fibrillation caused moderate-severe tricuspid regurgitation undergoing ablation (n = 411) were reviewed. The surgical cohort (n = 114) underwent surgical ablation and tricuspid valve repair; the catheter cohort (n = 279) was selected from those patients who had catheter ablation. RESULTS: The estimated actuarial 5-year survival rates were 96.8% (95% CI: 92.95–97.78) and 92.0% (95% CI: 85.26–95.78) in the catheter and surgical cohort, respectively. Tethering height was showed as independent risk factors for recurrent atrial fibrillation and tricuspid regurgitation in both cohorts. A matched group analysis using propensity-matched was conducted after categorizing total patients by tethering height < 6 mm and ≥ 6 mm. Kaplan–Meier analysis showed in patients with tethering height < 6 mm, there were no differences in survival from mortality, stroke, recurrent atrial fibrillation and tricuspid regurgitation between two groups. In patients with tethering height ≥ 6 mm, there were significantly higher cumulative incidence of stroke (95% CI, 0.047–0.849; P = 0.029), recurrent atrial fibrillation (95% CI, 0.357–09738; P = 0.039) and tricuspid regurgitation (95% CI, 0.359–0.981; P = 0.042) in catheter group. CONCLUSIONS: Atrial fibrillation caused tricuspid regurgitation resulted in less leaflets coaptation, which risk the recurrence of atrial fibrillation and tricuspid regurgitation. Patients whose tethering height was less than 6 mm showed satisfying improvement in tricuspid regurgitation with the restoration of sinus rhythm after catheter ablation. However, in patients with severe leaflets tethering, the results favored surgical over catheter. |
format | Online Article Text |
id | pubmed-7526327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75263272020-10-01 Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis Wang, Jiangang Li, Songnan Ye, Qing Ma, Xiaolong Zhao, Yichen Han, Jie Li, Yan Zheng, Shuai Liu, Kemin He, Meng Yu, Wen Sun, Junhui Meng, Xu J Cardiothorac Surg Research Article BACKGROUND: This study aimed to describe the mid-term outcomes of different treatments in patients with atrial fibrillation caused tricuspid regurgitation. METHODS: A retrospective study of patients diagnosed as atrial fibrillation caused moderate-severe tricuspid regurgitation undergoing ablation (n = 411) were reviewed. The surgical cohort (n = 114) underwent surgical ablation and tricuspid valve repair; the catheter cohort (n = 279) was selected from those patients who had catheter ablation. RESULTS: The estimated actuarial 5-year survival rates were 96.8% (95% CI: 92.95–97.78) and 92.0% (95% CI: 85.26–95.78) in the catheter and surgical cohort, respectively. Tethering height was showed as independent risk factors for recurrent atrial fibrillation and tricuspid regurgitation in both cohorts. A matched group analysis using propensity-matched was conducted after categorizing total patients by tethering height < 6 mm and ≥ 6 mm. Kaplan–Meier analysis showed in patients with tethering height < 6 mm, there were no differences in survival from mortality, stroke, recurrent atrial fibrillation and tricuspid regurgitation between two groups. In patients with tethering height ≥ 6 mm, there were significantly higher cumulative incidence of stroke (95% CI, 0.047–0.849; P = 0.029), recurrent atrial fibrillation (95% CI, 0.357–09738; P = 0.039) and tricuspid regurgitation (95% CI, 0.359–0.981; P = 0.042) in catheter group. CONCLUSIONS: Atrial fibrillation caused tricuspid regurgitation resulted in less leaflets coaptation, which risk the recurrence of atrial fibrillation and tricuspid regurgitation. Patients whose tethering height was less than 6 mm showed satisfying improvement in tricuspid regurgitation with the restoration of sinus rhythm after catheter ablation. However, in patients with severe leaflets tethering, the results favored surgical over catheter. BioMed Central 2020-09-29 /pmc/articles/PMC7526327/ /pubmed/32993732 http://dx.doi.org/10.1186/s13019-020-01336-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Wang, Jiangang Li, Songnan Ye, Qing Ma, Xiaolong Zhao, Yichen Han, Jie Li, Yan Zheng, Shuai Liu, Kemin He, Meng Yu, Wen Sun, Junhui Meng, Xu Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title | Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title_full | Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title_fullStr | Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title_full_unstemmed | Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title_short | Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis |
title_sort | catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. propensity score analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526327/ https://www.ncbi.nlm.nih.gov/pubmed/32993732 http://dx.doi.org/10.1186/s13019-020-01336-3 |
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