1. Contemporary management of patients undergoing atrial fibrillation ablation: in-hospital and 1-year follow-up findings from the ESC-EHRA atrial fibrillation ablation long-term registry
- Author
-
Arbelo, Elena, Brugada, Josep, Blomstrom-Lundqvist, Carina, Laroche, Cecile, Kautzner, Josef, Pokushalov, Evgeny, Raatikainen, Pekka, Efremidis, Michael, Hindricks, Gerhard, Barrera, Alberto, Maggioni, Aldo, Tavazzi, Luigi, Dagres, Nikolaos, ESC-EHRA Atrial Fibrillation, [Arbelo, Elena] Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain, [Brugada, Josep] Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain, [Blomstrom-Lundqvist, Carina] Uppsala Univ, Inst Med Sci, Dept Cardiol, Uppsala, Sweden, [Laroche, Cecile] European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France, [Maggioni, Aldo] European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France, [Kautzner, Josef] Inst Clin & Expt Med, Dept Cardiol, Prague, Czech Republic, [Pokushalov, Evgeny] State Res Inst Circulat Pathol, Arrhythmia Dept, Novosibirsk, Russia, [Pokushalov, Evgeny] State Res Inst Circulat Pathol, EP Lab, Novosibirsk, Russia, [Raatikainen, Pekka] Tampere Univ Hosp, Heart Ctr Co, Tampere, Finland, [Efremidis, Michael] Evangelismos Gen Hosp Athens, Lab Cardiac Electrophysiol, Dept Cardiol 2, Athens, Greece, [Hindricks, Gerhard] Univ Leipzig, Ctr Heart, Dept Electrophysiol, Leipzig, Germany, [Dagres, Nikolaos] Univ Leipzig, Ctr Heart, Dept Electrophysiol, Leipzig, Germany, [Barrera, Alberto] Univ Hosp Virgen de la Victoria, Dept Cardiol, Arrhythmia Unit, Malaga, Spain, [Maggioni, Aldo] Assoc Nazl Med Cardiol Osped Res Ctr AMCO Res Ctr, Florence, Italy, [Tavazzi, Luigi] Maria Cecilia Hosp, ES Hlth Sci Fdn, GVM Care & Res, Cotignola, Italy, Abbott Vascular Int., Amgen Cardiovascular, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Pfizer Alliance, Alliance Daiichi Sankyo Europe GmbH, Eli Lilly and Company, Gedeon Richter Plc., Menarini Int. Op., MSD-Merck Co., Novartis Pharma AG, ResMed, Sanofi, and SERVIER
- Subjects
Male ,medicine.medical_specialty ,Complications ,medicine.medical_treatment ,1 year follow up ,Outcomes ,Ablation ,Guidelines ,030204 cardiovascular system & hematology ,Pulmonary vein ,03 medical and health sciences ,Antithrombotic treatment ,0302 clinical medicine ,Postoperative Complications ,Internal medicine ,Atrial Fibrillation ,Preoperative Care ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Registries ,Multicenter ,business.industry ,Radiofrequency ablation ,Anticoagulants ,Eurobservational research-program ,Atrial fibrillation ,Length of Stay ,Middle Aged ,medicine.disease ,Management ,Surgery ,Clinical Practice ,Atrioesophageal fistula ,Europe ,Hospitalization ,Prospective registry ,Cardiology ,Catheter Ablation ,Lone atrial fibrillation ,Catheter ablation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Aims The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. Methods and results A total of 104 centres in 27 European countries participated and were asked to enrol 20–50 consecutive patients scheduled for first and re-do AFib ablation. Pre-procedural, procedural and 1-year follow-up data were captured on a web-based electronic case record form. Overall, 3630 patients were included, of which 3593 underwent an AFib ablation (98.9%). Median age was 59 years and 32.4% patients had lone atrial fibrillation. Pulmonary vein isolation was attempted in 98.8% of patients and achieved in 95–97%. AFib-related symptoms were present in 97%. In-hospital complications occurred in 7.8% and one patient died due to an atrioesophageal fistula. One-year follow-up was performed in 3180 (88.6%) at a median of 12.4 months (11.9–13.4) after ablation: 52.8% by clinical visit, 44.2% by telephone contact and 3.0% by contact with the general practitioner. At 12-months, the success rate with or without antiarrhythmic drugs (AADs) was 73.6%. A significant portion (46%) was still on AADs. Late complications included 14 additional deaths (4 cardiac, 4 vascular, 6 other causes) and 333 (10.7%) other complications. Conclusion AFib ablation in clinical practice is mostly performed in symptomatic, relatively young and otherwise healthy patients. Overall success rate is satisfactory, but complication rate remains considerable and a significant portion of patients remain on AADs. Monitoring after ablation shows wide variations. Antithrombotic treatment after ablation shows insufficient guideline-adherence.
- Published
- 2016