ESC Congress 2004: Worldwide survey on catheter ablation for human atrial fibrillation

August 29, 2004

Introduction. After its introduction in 1994, CA of AF has shown curative potential and according to the literature, one every four patients with AF could represent a candidate for this therapy in clinical practice.

Aim of the study. The purpose of this study was to conduct a worldwide survey investigating the methods, efficacy and safety of catheter ablation (CA) of atrial fibrillation (AF).

Methods and Results. A detailed questionnaire was sent to 777 centers worldwide. The centers were selected from official sources of national or international societies. The questionnaire was conceived to examine the following post-ablation outcome parameters: freedom from recurrent AF in the absence of antiarrhythmic drugs; freedom from recurrent AF in the presence of formerly ineffective antiarrhythmic drugs; overall freedom from recurrent AF (i.e., both in the absence and the presence of orally administered antiarrhythmic drugs); and, development of major complications.

Data relevant to the study purpose were collected from 181 centers (23.3%), of which 100 had ongoing programs on CA of AF between 1995 and 2002. The number of patients undergoing this procedure increased from 18 in 1995 to 5,050 in 2002. The median number of procedures per center was 37.5 (range, 1 - 600). Paroxysmal, persistent and permanent AF were the indicated arrhythmias in 100.0%, 53.0% and 20.0% of responding centers, respectively. The most commonly used techniques were right atrial compartmentalization between 1995 and 1997, ablation of the triggering focus in 1998 and 1999 and electrical disconnection of multiple pulmonary veins between 2000 and 2002. Out of 8,745 patients completing the CA protocol in 90 centers, of whom 2,389 (27.3%) required more than one procedure, 4,550 (52.0%) became asymptomatic without drugs and other 2,094 (23.9%) became asymptomatic in the presence of formerly ineffective antiarrhythmic drugs over 11. 6 ± 7.7 months follow up.

A major complication occurred in 524 patients (6.0%) (see table). The most significant complications included 4 patient early deaths (extra-pericardial PV perforation in 1, massive cerebral thrombo-embolism in 2 and unknown in 1), 20 strokes, 47 transient ischemic attacks and 107 episodes of tamponade. Altogether, 117 PVs sustained significant (>50%) stenosis , which resulted in the need for a corrective intervention in 53 patients (0.7% of 7,154 patients undergoing ablation in the left atrium). Atypical atrial flutter of new onset (iatrogenic) was reported in 340 patients (3.9%), and was significantly (p < 0.001) more frequently observed in centers using exclusively 3D-guided compartmentalization strategies (8.4%) than in centers performing exclusively ablation of the triggering substrate or PV electrical disconnection (0.8%)

Conclusions. The findings of this survey provide a picture of the variable and evolving methods, efficacy and safety of CA of AF as practiced in a large number of laboratories worldwide and may serve as a guide to clinicians considering therapeutic options in patients suffering from this arrhythmia.
R Cappato

This press release accompanies both a presentation and an ESC press conference given at the ESC Congress 2004. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology

European Society of Cardiology

Related Atrial Fibrillation Articles from Brightsurf:

Atrial fibrillation less deadly than it used to be, but still cause for concern: BU study
A first-of-its-kind study by researchers from the Boston University School of Public Health (BUSPH) shows a decline in deaths related to atrial fibrillation (irregular heartbeat) over the last 45 years.

Postoperative atrial fibrillation does not impact on overall survival after esophagectomy
Volume 11, Issue 25 of Oncotarget reported that Administration of landiolol hydrochloride was found to be associated with reduced incidence of atrial fibrillation after esophagectomy for esophageal cancer in our previous randomized controlled trial.

People with atrial fibrillation live longer with exercise
More than 100,000 Norwegians have atrial fibrillation. They should be actively exercising for their health.

Atrial fibrillation among overweight people is not due to fat
In a recently published study, researchers from Aarhus University document that the risk of atrial fibrillation is not linked to the amount of body fat, but instead to large muscle mass, or more precisely, a high fat-free weight

Eating more protein could help ward off atrial fibrillation in women
Women who ate slightly more than the recommended daily amount of protein were significantly less likely to develop atrial fibrillation (AFib), a dangerous heart rhythm disorder that can lead to stroke and heart failure, when compared with those who consumed less protein, according to research being presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Zebrafish teach researchers more about atrial fibrillation
Genetic research in zebrafish at the University of Copenhagen has surprised the researchers behind the study.

Personalized medicine for atrial fibrillation
The study, published in Europace, uses signals from implantable devices -- pacemakers and defibrillators -- to analyze electrical signals in the heart during episodes of atrial fibrillation.

Prescribing anticoagulants in the ED for atrial fibrillation increases long-term use by 30%
Patients prescribed anticoagulants after a diagnosis of atrial fibrillation in the emergency department are more likely to continue long-term use of medications to treat the condition, according to research published in CMAJ (Canadian Medical Association Journal).

Anticoagulant benefits for atrial fibrillation decrease with age
The net clinical benefit of anticoagulants for atrial fibrillation (AF) -- one of the most important causes of irregular heartbeats and a leading cause of stroke -- decreases with age, as the risk of death from other factors diminishes their benefit in older patients, according to a study led by researchers at UC San Francisco.

Research improves understanding of mechanism of atrial fibrillation
Mouse model studies show that noncoding DNA regions linked to atrial fibrillation risk can display long-range regulatory functions directed at Pitx2 gene and in this way predispose to the condition.

Read More: Atrial Fibrillation News and Atrial Fibrillation Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to