April 17, 2017
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Many patients with AF become asymptomatic after catheter ablation

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According to data from the European Society of Cardiology–European Heart Rhythm Association registry published in European Heart Journal, more than half of patients with atrial fibrillation are asymptomatic after catheter ablation.

The ESC-EHRA AF ablation long-term registry is a prospective, multinational study that aimed to describe the real-life clinical epidemiology of patients undergoing AF ablation procedures.

“High-risk patients who do not receive oral anticoagulation have a greater chance of stroke,” Elena Arbelo, MD, PhD, from the Cardiovascular Institute, Hospital Clinic de Barcelona, Spain, said in a press release. “According to our registry, 91% of patients choose to undergo an ablation for relief of symptoms and 66% to improve their quality of life.”

The study included 104 centers in 27 countries throughout Europe, each enrolling 20 to 50 patients who were scheduled for first and re-do AF ablation, according to the researchers.

They used a web-based electronic case record form to collect preprocedural, procedural and 1-year follow-up data.

A total of 3,630 patients (median age, 59 years) were included in the study and 3,593 (98.9%) received an AF ablation.

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Overall, 32.4% of patients had lone AF, and pulmonary vein isolation was achieved in 95% to 97% of patients.

A total of 97% of patients showed AF-related symptoms, according to the data.

In-hospital complications occurred in 7.8% of patients and one patient died due to an atrioesophageal fistula.

There were 3,180 patients (88.6%) who had 1-year follow-up at a median of 12.4 months after ablation: 52.8% by clinical visit, 44.2% by telephone contact and 3% by contact with the general practitioner, the researchers wrote.

The success rate with or without antiarrhythmic drugs at 1 year was 73.6%, with 46% of patients still on antiarrhythmic drugs.

Late complications included four cardiac deaths, four vascular deaths and six deaths from other causes, along with 333 (10.7%) other complications, according to the findings.

“Catheter ablation is not open-heart surgery, but it is still an invasive procedure that has risks. It is disappointing that 40% of patients are not being comprehensively monitored afterward,” Arbelo said in the release. “Patients and referring doctors should be aware that complications can occur. Catheter ablation should be done in centers and by electrophysiologists with sufficient experience to minimize the risk.” – by Dave Quaile

Disclosure: The program that generated the study was supported by Abbott Vascular, Amgen Cardiovascular, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb/Pfizer, Daiichi Sankyo/Eli Lilly, Gedeon Richter, Menarini, Merck, Novartis, ResMed, Sanofi and Servier. Arbelo reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.