No abstract

Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia. Catheter Ablation (CA) is considered as a first-line therapy for AF. The risk of 30-days all-cause mortality associated with CA for AF may be underestimated in clinical trials and selected-cohort studies due to selection bias. Hypothesis: We evaluated 30-days all-cause mortality associated with CA for AF in the entire country of Poland Methods: The data was collected from the Polish national healthcare service (the National Health Fund of Poland). In the Polish health system covers >99% of CA for AF for the entire country. All consecutive CA in patients >18 years of age, between Jan 2012 and Dec 2019 were included in the study. CA for AF was identified by unique codes assigned to pulmonary vein isolation and CA for AF. The mortality rate was calculated for each age group. Results: During 8-year follow-up period, 31,214 CA of AF were performed in 26,767 patients. 9315 (34.8%) patients were female. 13758 (51.4%) patients had Cryoballoon ablation. Thirty-two deaths (0.1%) within 30-days of the CA were identified. The mortality rate was low and similar in each age group except in the oldest age group (age>80). The oldest age group had significantly higher 30-days mortality than any other age group. (Figure). Conclusions: In the large, consecutive patient population in the entire country of Poland, 30- days mortality following AF ablation for past 8-years remains low. In real-world clinical practice patients over the age of 80 have higher risk of 30-day all-cause mortality than any other age group found over last seven years. Systematic review is needed to further risk-stratify these findings.

Inflammation, high sympathetic tone, electrolyte changes and chronic kidney disease (CKD) are among the risk factors of postoperative atrial fibrillation (AF).(1) Studies show that elevated C-reactive protein levels may predict recurrent atrial arrhythmias (2) We present a case of a 70-year-old woman with paroxysmal atrial fibrillation who developed systemic inflammatory response syndrome and underwent unsuccessful electrical cardioversion of AF after pacemaker implantation.A 70-year-old woman diagnosed with symptomatic tachycardia-bradycardia syndrome, paroxysmal AF, chronic heart failure (NYHA II), hypertension, chronic kidney disease, after laparoscopic adrenalectomy due to Cushing syndrome, after mastectomy due to breast cancer was referred to the Department of Arrhythmias, Institute of Cardiology, Warsaw for pacemaker implantation. Physical examination revealed good general condition, lower limb edema and vaginal erythematous skin lesions corresponding to the clinical manifestation of candidiasis. Sinus rhythm with a heart rate of 62 beats per minute (bpm) was observed on ECG. At entry, laboratory investigations showed: white blood count (WBC)1071 cells/mm3; C-reactive protein 0.55 mg/dl; creatinine 1.4 ml/ min/1.73 m2; urea 79.4 mg/dl. Urine tests were performed at admission, showing no abnormalities. The patient underwent dual chamber pacemaker (DDD) implantation preceded by 1.5 g cefuroxime infusion. In the early post-implantation period AF with a high ventricular rate (150 bpm) was observed. Electrical cardioversion was performed to restore sinus rhythm. In 3 hours after successful intervention, sinus