Prophylactic radiofrequency ablation in asymptomatic patients with Wolff-Parkinson-White is not yet a good strategy: a decision analysis.
Identifieur interne : 000774 ( PubMed/Corpus ); précédent : 000773; suivant : 000775Prophylactic radiofrequency ablation in asymptomatic patients with Wolff-Parkinson-White is not yet a good strategy: a decision analysis.
Auteurs : Philippe Chevalier ; France Cadi ; Alina Scridon ; Nicolas Girerd ; Theodora Bejan-Angoulvan ; Elodie Morel ; Isabelle Jaisson Hot ; Sylvie Di Filippo ; Christell Ganne ; Cyrille ColinSource :
- Circulation. Arrhythmia and electrophysiology [ 1941-3084 ] ; 2013.
English descriptors
- KwdEn :
- Adult, Asymptomatic Diseases, Catheter Ablation (adverse effects), Death, Sudden, Cardiac (prevention & control), Decision Support Techniques, Decision Trees, Electrocardiography, Humans, Patient Selection, Risk Assessment, Risk Factors, Software, Time Factors, Treatment Outcome, Wolff-Parkinson-White Syndrome (diagnosis), Wolff-Parkinson-White Syndrome (mortality), Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (surgery), Young Adult.
- MESH :
- adverse effects : Catheter Ablation.
- diagnosis : Wolff-Parkinson-White Syndrome.
- mortality : Wolff-Parkinson-White Syndrome.
- physiopathology : Wolff-Parkinson-White Syndrome.
- prevention & control : Death, Sudden, Cardiac.
- surgery : Wolff-Parkinson-White Syndrome.
- Adult, Asymptomatic Diseases, Decision Support Techniques, Decision Trees, Electrocardiography, Humans, Patient Selection, Risk Assessment, Risk Factors, Software, Time Factors, Treatment Outcome, Young Adult.
Abstract
Therapeutic management of asymptomatic patients with a Wolff-Parkinson-White (WPW) pattern is controversial. We compared the risk:benefit ratios between prophylactic radiofrequency ablation and no treatment in asymptomatic patients with WPW.
DOI: 10.1161/CIRCEP.112.970459
PubMed: 23362302
Links to Exploration step
pubmed:23362302Le document en format XML
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Arrhythmia and electrophysiology</title><idno type="eISSN">1941-3084</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Asymptomatic Diseases</term><term>Catheter Ablation (adverse effects)</term><term>Death, Sudden, Cardiac (prevention & control)</term><term>Decision Support Techniques</term><term>Decision Trees</term><term>Electrocardiography</term><term>Humans</term><term>Patient Selection</term><term>Risk Assessment</term><term>Risk Factors</term><term>Software</term><term>Time Factors</term><term>Treatment Outcome</term><term>Wolff-Parkinson-White Syndrome (diagnosis)</term><term>Wolff-Parkinson-White Syndrome (mortality)</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term><term>Wolff-Parkinson-White Syndrome (surgery)</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Catheter Ablation</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Death, Sudden, Cardiac</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Asymptomatic Diseases</term><term>Decision Support Techniques</term><term>Decision Trees</term><term>Electrocardiography</term><term>Humans</term><term>Patient Selection</term><term>Risk Assessment</term><term>Risk Factors</term><term>Software</term><term>Time Factors</term><term>Treatment Outcome</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Therapeutic management of asymptomatic patients with a Wolff-Parkinson-White (WPW) pattern is controversial. We compared the risk:benefit ratios between prophylactic radiofrequency ablation and no treatment in asymptomatic patients with WPW.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23362302</PMID><DateCreated><Year>2013</Year><Month>02</Month><Day>20</Day></DateCreated><DateCompleted><Year>2013</Year><Month>04</Month><Day>18</Day></DateCompleted><DateRevised><Year>2013</Year><Month>08</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1941-3084</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><Issue>1</Issue><PubDate><Year>2013</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Circulation. Arrhythmia and electrophysiology</Title><ISOAbbreviation>Circ Arrhythm Electrophysiol</ISOAbbreviation></Journal><ArticleTitle>Prophylactic radiofrequency ablation in asymptomatic patients with Wolff-Parkinson-White is not yet a good strategy: a decision analysis.</ArticleTitle><Pagination><MedlinePgn>185-90</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1161/CIRCEP.112.970459</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Therapeutic management of asymptomatic patients with a Wolff-Parkinson-White (WPW) pattern is controversial. We compared the risk:benefit ratios between prophylactic radiofrequency ablation and no treatment in asymptomatic patients with WPW.</AbstractText><AbstractText Label="METHODS AND RESULTS" NlmCategory="RESULTS">Decision analysis software was used to construct a risk-benefit decision tree. The target population consisted of 20- to 40-year-old asymptomatic patients with WPW without structural fatal heart disease or a family history of sudden cardiac death. Baseline estimates of sudden death and radiofrequency ablation complication rates were obtained from the literature, an empirical data survey, and expert opinion. The outcome measure was death within 10 years. Sensitivity analyses determined the variables that significantly impacted the decision to ablate or not. Threshold analyses evaluated the effects of key variables and the optimum policy. At baseline, the decision to ablate resulted in a reduction of mortality risk of 8.8 patients for 1000 patients compared with abstention. It is necessary to treat 112 asymptomatic patients with WPW to save one life over 10 years. Sensitivity analysis showed that 3 variables significantly impacted the decision to ablate: (1) complication of radiofrequency ablation, (2) success of radiofrequency ablation, and (3) sudden death in asymptomatic patients with WPW.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This study provides a decision aid for treating asymptomatic patients with the WPW ECG pattern. Using the model and the population we tested, prophylactic catheter ablation is not yet ready for widespread clinical use.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chevalier</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Rhythmology Unit, Louis Pradel Cardiology Hospital, Bron, Hospices Civils de Lyon, Lyon, France. philippe.chevalier@chu-lyon.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cadi</LastName><ForeName>France</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Scridon</LastName><ForeName>Alina</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Girerd</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Bejan-Angoulvan</LastName><ForeName>Theodora</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Morel</LastName><ForeName>Elodie</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Hot</LastName><ForeName>Isabelle Jaisson</ForeName><Initials>IJ</Initials></Author><Author ValidYN="Y"><LastName>Di Filippo</LastName><ForeName>Sylvie</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Ganne</LastName><ForeName>Christell</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Colin</LastName><ForeName>Cyrille</ForeName><Initials>C</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>01</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Circ Arrhythm Electrophysiol</MedlineTA><NlmUniqueID>101474365</NlmUniqueID><ISSNLinking>1941-3084</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Circ Arrhythm Electrophysiol. 2013 Jun;6(3):e39</RefSource><PMID Version="1">23778254</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Circ Arrhythm Electrophysiol. 2013 Jun;6(3):e38</RefSource><PMID Version="1">23778253</PMID></CommentsCorrections><CommentsCorrections RefType="ErratumIn"><RefSource>Circ Arrhythm Electrophysiol. 2013 Jun;6(3):e40</RefSource></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058070" MajorTopicYN="N">Asymptomatic Diseases</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017115" MajorTopicYN="Y">Catheter Ablation</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016757" MajorTopicYN="N">Death, Sudden, Cardiac</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003661" MajorTopicYN="Y">Decision Support Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003663" MajorTopicYN="N">Decision Trees</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018579" MajorTopicYN="Y">Patient Selection</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018570" MajorTopicYN="N">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012984" MajorTopicYN="N">Software</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014927" MajorTopicYN="N">Wolff-Parkinson-White Syndrome</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>1</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>1</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>4</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23362302</ArticleId><ArticleId IdType="pii">CIRCEP.112.970459</ArticleId><ArticleId IdType="doi">10.1161/CIRCEP.112.970459</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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