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National Heart Foundation of Australia consensus statement on catheter ablation as a therapy for atrial fibrillation.
MedLine Citation:
PMID:  23330766     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Atrial fibrillation (AF) is estimated to affect 1%-2% of the population. It is increasing in prevalence and is associated with excess mortality, considerable morbidity and hospitalisations. AF is responsible for a significant and growing societal financial burden. Catheter ablation is an increasingly used therapeutic strategy for the management of AF; however, some confusion exists among those caring for patients with this condition about the role and optimal use of ablative treatments for AF. Our aim in this consensus statement is to provide recommendations on the use of primary catheter ablation for AF in Australia, on the basis of current evidence. Our consensus is that the primary indication for catheter ablation of AF is the presence of symptomatic AF that is refractory or intolerant to at least one Class 1 or Class 3 antiarrhythmic medication. In selecting patients for catheter ablation of AF, consideration should be given to the patient's age, duration of AF, left atrial size and the presence of significant structural heart disease. Best results are obtained in younger patients with paroxysmal AF, no structural heart disease and smaller atria. Ablation techniques for patients with persistent AF are still undergoing evaluation. Discontinuation of warfarin or equivalent therapies is not considered a sole indication for this procedure. After AF ablation, anticoagulation therapy is generally recommended for all patients for at least 1-3 01s. Discontinuation of warfarin or equivalent therapies after ablation is generally not recommended in patients who have a CHADS 2 score (congestive heart failure, hypertension, age ≥ 75 2013s, diabetes, 1 point each; prior stroke or transient ischaemic attack, 2 points) of ≥ 2.
Authors:
Jonathan M Kalman; Prashanthan Sanders; David B Brieger; Anu Aggarwal; Nick A Zwar; James Tatoulis; Andre E Tay; Alison Wilson; Maree G Branagan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  198     ISSN:  1326-5377     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  27-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
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