The Atrial Fibrillation Ablation Pilot Study: An European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association
Articolo
Data di Pubblicazione:
2014
Citazione:
The Atrial Fibrillation Ablation Pilot Study: An European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association / A. Elena, B. Josep, H. Gerhard, M. Aldo P., T. Luigi, V. Panos, L. Cã©cile, A. Frã©dã©ric, I. Giuseppe, J. Pierre, K. Zbigniew, K. Josef, L. Thorsten, M. Georges H., P. Julian, R. Sam, T. Milos, T. George, Trines, S. A, C. Tondo. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 35:22(2014 Jun 07), pp. 1466-1478. [10.1093/eurheartj/ehu001]
Abstract:
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. © The Author 2014.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Atrial fibrillation; Catheter ablation; Outcomes; Registry; Survey; Anti-Arrhythmia Agents; Atrial Fibrillation; Catheter Ablation; Electrocardiography; Humans; Kaplan-Meier Estimate; Patient Readmission; Pilot Projects; Postoperative Care; Prospective Studies; Recurrence; Treatment Outcome; Cardiology and Cardiovascular Medicine
Elenco autori:
A. Elena, B. Josep, H. Gerhard, M. Aldo P., T. Luigi, V. Panos, L. Cã©cile, A. Frã©dã©ric, I. Giuseppe, J. Pierre, K. Zbigniew, K. Josef, L. Thorsten, M. Georges H., P. Julian, R. Sam, T. Milos, T. George, Trines, S. A, C. Tondo
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