Document Detail


Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation.
MedLine Citation:
PMID:  19995881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to provide an updated worldwide report on the methods, efficacy, and safety of catheter ablation of atrial fibrillation (AF).
METHODS AND RESULTS: A questionnaire with 46 questions was sent to 521 centers from 24 countries in 4 continents. Complete interviews were collected from 182 centers, of which 85 reported to have performed 20,825 catheter ablation procedures on 16,309 patients with AF between 2003 and 2006. The median number of procedures per center was 245 (range, 2 to 2715). All centers included paroxysmal AF, 85.9% also included persistent and 47.1% also included long-lasting AF. Carto-guided left atrial circumferential ablation (48.2% of patients) and Lasso-guided ostial electric disconnection (27.4%) were the most commonly used techniques. Efficacy data were analyzed with centers representing the unit of analysis. Of 16,309 patients with full disclosure of outcome data, 10 488 (median, 70.0%; interquartile range, 57.7% to 75.4%) became asymptomatic without antiarrhythmic drugs and another 2047 (10.0%; 0.5% to 17.1%) became asymptomatic in the presence of previously ineffective antiarrhythmic drugs over 18 (range, 3 to 24) months of follow-up. Success rates free of antiarrhythmic drugs and overall success rates were significantly larger in 9590 patients with paroxysmal AF (74.9% and 83.2%) than in 2800 patients with persistent AF (64.8% and 75.0%) and 1108 patients with long-lasting AF (63.1% and 72.3%) (P<0.0001). Major complications were reported in 741 patients (4.5%).
CONCLUSIONS: When analyzed in a large number of electrophysiology laboratories worldwide, catheter ablation of AF shows to be effective in approximately 80% of patients after 1.3 procedures per patient, with approximately 70% of them not requiring further antiarrhythmic drugs during intermediate follow-up.
Authors:
Riccardo Cappato; Hugh Calkins; Shih-Ann Chen; Wyn Davies; Yoshito Iesaka; Jonathan Kalman; You-Ho Kim; George Klein; Andrea Natale; Douglas Packer; Allan Skanes; Federico Ambrogi; Elia Biganzoli
Publication Detail:
Type:  Journal Article     Date:  2009-12-07
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  3     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-03-09     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-8     Citation Subset:  IM    
Affiliation:
Arrhythmias and Electrophysiology Center, IRCCS, Policlinico San Donato, Milan, Italy. riccardo.cappato@grupposandonato.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants / therapeutic use
Atrial Fibrillation / surgery*
Catheter Ablation* / adverse effects,  methods
Data Collection
Female
Humans
Male
Middle Aged
Questionnaires
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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