1 The Faculty of Medicine, Aalborg University, VBN2 Aalborg University Hospital, The Faculty of Medicine, Aalborg University, VBN3 Klinik Hjerte-Lunge, The Faculty of Medicine, Aalborg University, VBN4 Hjertemedicin (Kardiologi), The Faculty of Medicine, Aalborg University, VBN5 Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain.6 Heart Center, University of Leipzig, Leipzig, Germany.7 EURObservational Research Programme, European Society of Cardiology, Sophia - Antipolis, France.8 GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Cotignola, Italy.9 Heraklion University Hospital10 Service De Cardiologie, Hôpital Charles Nicolle, Rouen Cedex, France.11 Ospedale Maggiore12 Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France.13 Department of Cardiology, Silesian Academy of Medicine, Zabrze, Poland.14 Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.15 Department of Cardiology, Isar Heart Centre, Muenchen, Germany.16 Cliniques du Sud Luxembourg - Vivalia, Arlon, Belgium.17 Hospital Clinico San Carlos, Madrid, Spain.18 Internal Cardiology Department, Faculty Hospital Olomouc, Olomouc, Czech Republic.19 Henry Dunant Hospital20 Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.21 unknown22 Heraklion University Hospital23 Ospedale Maggiore24 Henry Dunant Hospital
an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association
AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analyse how centres assess in routine clinical practice the success of the procedure and to evaluate the success rate and long-term safety/complications. METHODS AND RESULTS: Seventy-two centres in 10 European countries were asked to enrol 20 consecutive patients undergoing a first AFib ablation procedure. A web-based case report form captured information on pre-procedural, procedural, and 1-year follow-up data. Between October 2010 and May 2011, 1410 patients were included and 1391 underwent an AFib ablation (98.7%). A total of 1300 patients (93.5%) completed a follow-up control 367 ± 42 days after the procedure. Arrhythmia documentation was done by an electrocardiogram in 76%, Holter-monitoring in 52%, transtelephonic monitoring in 8%, and/or implanted systems in 4.5%. Over 50% became asymptomatic. Twenty-one per cent were re-admitted due to post-ablation arrhythmias. Success without antiarrhythmic drugs was achieved in 40.7% of patients (43.7% in paroxysmal AF; 30.2% in persistent AF; 36.7% in long-lasting persistent AF). A second ablation was required in 18% of the cases and 43.4% were under antiarrhythmic treatment. Thirty-three patients (2.5%) suffered an adverse event, 272 (21%) experienced a left atrial tachycardia, and 4 patients died (1 haemorrhagic stroke, 1 ventricular fibrillation in a patient with ischaemic heart disease, 1 cancer, and 1 of unknown cause). CONCLUSION: The AFib Ablation Pilot Study provided crucial information on the epidemiology, management, and outcomes of catheter ablation of AFib in a real-world setting. The methods used to assess the success of the procedure appeared at least suboptimal. Even in this context, the 12-month success rate appears to be somewhat lower to the one reported clinical trials.
European Heart Journal, 2014, Vol 35, Issue 22, p. 1466-1478