Abstract 17591: New Methods to Display and Summarize Late Reintervention Outcomes, Follow-Up and Vital Status Information After Surgery for Atrial Fibrillation
Background: There are limited statistical methods to display certain clinically important interventions in patients that undergo catheter ablation (CA) or cardioversion (CV) after surgical ablation of atrial fibrillation (SAAF). Current reporting is limited to yearly or last follow-up summaries and does not convey the outcome dynamics over time. Following a recommendation of the 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and SAAF to develop new robust outcome reporting methods, we propose a comprehensive measure of the overall burden of reintervention after SAAF.
Methods: 729 patients (60% males, age 67±12 yrs, follow-up 3.3±1.9 yrs, 92% 1-yr survival) underwent SAAF with or without concomitant cardiac surgery between 04/04 and 12/10. Of them, N=141 patients had a total of R=232 late reinterventions grouped as follows: (a) CAs alone (N=21, R=24), (b) CVs alone (N=87, R=111), (c) at least a CA and a CV (N=33, R=97). As a robust reporting measure, we propose the mean cumulative number MCF(t) of reinterventions per individual up to time t. It facilitates comparisons of MCF(t) to benchmarks, among MCF(t) at different times or in different groups.
Results: Figure panel A indicates that 14 of 24 CA (58%), 87 of 111 CV (78%) and 53 of 97 CA+CV (55%) reinterventions occur within one year after SAAF. Panel B displays MCF(t) and 95% confidence intervals by group. For CA, the MCF(t) relative increase is highest during year 1 (Y1) and it attenuates subsequently: 55% from 6 months to Y1, 37% Y1 to Y2, 24% Y2 to Y3, 0% Y3 to Y4 and 10% Y4 to Y5. For CV, these increases were 27%, 15%, 11%, 10% and 6%. For CA+CV, increases were 53%, 52%, 12%, 8% and 3%.
Conclusion: The mean cumulative number of reinterventions is a rigorous summary of reinterventions outcomes after SAAF and it provides a new temporal perspective of the outcomes.
- © 2012 by American Heart Association, Inc.