Overcoming reporting challenges: How to display, summarize, and model late reintervention outcomes, follow-up, and vital status information after surgery for atrial fibrillation

Adin-Cristian Andrei*, Patrick M McCarthy, James David Thomas, Travis O. Abicht, S Chris Malaisrie, Zhi Li, Jane Kruse, Albert L. Waldo, Hugh Calkins, James Lewis Cox

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background Postsurgical late reinterventions for atrial fibrillation (AF) include cardioversions (CV) or catheter ablations (CA). Commonly used methods for reporting and modeling the frequency and timing of CA or CV have well-known shortcomings. Objective The purpose of this study was to present intuitive and robust methods to visualize, summarize, and model late reinterventions type/timing and vital status simultaneously. Methods We present (1) the SMART plot (Summary of Mortality And Outcomes Reported Over Time); (2) the reintervention mean cumulative function (MCF); and (3) the proportional means model and the proportional rates model. We illustrate these methods in 3 groups: patients age ≤60 years, 60-75 years (reference), and >75 years who underwent surgical AF ablation. Results Patients age >75 years had a significantly lower MCF of CVs (hazard ratio [HR] 0.50, P <.001). MCF for CAs was not significantly lower for patients age >75 years (HR 0.57, P =.13). For combined reinterventions (CV or CA), the age group >75 years had a significantly lower MCF (HR 0.51, P <.001). There were no significant differences in late CV or CA reintervention patterns for patients age ≤60 years. Conclusion The methods presented provide a comprehensive framework for displaying, summarizing, and modeling repeated late reinterventions after surgical AF ablation. Other areas of application are described, further emphasizing the potential for immediate use.

Original languageEnglish (US)
Pages (from-to)1456-1463
Number of pages8
JournalHeart rhythm
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2015

Keywords

  • Atrial fibrillation
  • Cardioversion
  • Catheter ablation
  • Late reintervention
  • Recurrent event
  • Surgical ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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