Pacemaker implantation after catheter ablation for XXXX .

@entity1 @entity712 @entity1817 @entity9054 @entity955 @entity453
BACKGROUND: @entity1817 requiring pacemaker implantation is commonly associated with @entity955 ( @entity955 ), but may not be clinically apparent until restoration of sinus rhythm with ablation or cardioversion. We sought to determine frequency, time course, and predictors for pacemaker implantation after catheter ablation, and to compare the overall rates to a matched cardioversion cohort. METHODS AND RESULTS: We conducted a retrospective analysis using a large US commercial insurance database and identified 12,158 @entity955 @entity1 who underwent catheter ablation between January 1, 2005 and December 31, 2012. Over an average of 2.4  years of follow-up, 5.6  % of the @entity1 underwent pacemaker implantation. Using the Cox proportional hazards models, we found that risk of risks of pacemaker implantation was associated with older age (50-64 and >= 65 versus <50  years), female gender, higher CHADS2 score (>= 2 and 1 versus 0), higher Charlson index (>= 2 versus 0-1), certain baseline comorbidities ( @entity9054 , @entity453 , and @entity712 ), and the year of ablation. There was no significant difference in the risk of pacemaker implantation between ablation @entity1 and propensity score (PS)-matched cardioversion groups (3.5 versus. 4.1  % at 1  year and 8.8 versus 8.3  % at 5  years). CONCLUSION: Overall, pacemaker implantation occurs in about 1/28 @entity1 within 1  year of catheter ablation. The overall implantation rate decreased between 2005 and 2012. Furthermore, the risk after ablation is similar to cardioversion, suggesting that @entity1 require pacing due to a common underlying electrophysiologic substrate, rather than the ablation itself.
