title: Temporal changes in patient characteristics and prior pharmacotherapy in patients undergoing radiofrequency ablation of atrial fibrillation: a Danish nationwide cohort study.
abstract: OBJECTIVE
  Trends in patient selection and pharmacotherapy before radiofrequency ablation (RFA) of atrial fibrillation are not well studied. We examined temporal trends in RFA utilization on a nationwide scale in Denmark.
  
  
  RESULTS
  Using the cross-linkage of nationwide registers, 3302 atrial fibrillation patients treated with 'first-ever' RFA between 2000 and 2009 were identified. Median age was 59 years (interquartile range 53-65) and 73.8% were males. From 2000-01 to 2008-09 the median age increased from 55 (48-61) to 61 (55-66) years (P < 0.0001). The proportion of patients with hypertension and diabetes mellitus increased from 34.8 to 50.6% (P < 0.0001) and 2.2 to 5.9% (P < 0.01), respectively. The proportion of patients with heart failure, vascular disease or previous stroke remained unchanged. The percentage of patients with CHA2DS2-VASc score ≥2 increased from 23.9 to 41.5% (P < 0.0001). The proportion of patients who did not receive any class Ic or class III antiarrhythmic drugs (AADs) within 2 years prior to 'first-ever' RFA increased from 8.7 to 22.7% (P < 0.0001). Prior use of sotalol and class Ic AADs decreased from 63 to 6.3% (P < 0.0001) and from 35 to 24% (P < 0.0001), respectively. Amiodarone and beta-blockers prior to RFA were used in 36 and 82% of all patients, respectively, without significant temporal changes.
  
  
  CONCLUSIONS
  During a 10-year period, RFA was increasingly performed in older patients with higher co-morbidity, and without prior trial of antiarrhythmic therapy. These findings may provide a framework to understand the outcomes of RFA.
authors.affiliation: Department of Cardiology-post 635, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, Hellerup, Denmark. dkarasoy@gmail.com
authors.forename: Deniz
authors.initials: D
authors.lastname: Karasoy
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.forename: Jim
authors.initials: J
authors.lastname: Hansen
authors.forename: Jonas Bjerring
authors.initials: JB
authors.lastname: Olesen
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Arne
authors.initials: A
authors.lastname: Johannessen
authors.forename: Morten Lock
authors.initials: ML
authors.lastname: Hansen
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000628:therapy*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents