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Observational Study
. 2017 May 1;38(17):1303-1316.
doi: 10.1093/eurheartj/ehw564.

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

Elena Arbelo  1 , Josep Brugada  1 , Carina Blomström-Lundqvist  2 , Cécile Laroche  3 , Josef Kautzner  4 , Evgeny Pokushalov  5 , Pekka Raatikainen  6 , Michael Efremidis  7 , Gerhard Hindricks  8 , Alberto Barrera  9 , Aldo Maggioni  3   10 , Luigi Tavazzi  11 , Nikolaos Dagres  8 ; on the behalf of the ESC-EHRA Atrial Fibrillation Ablation Long-term Registry Investigators
Affiliations
Free article
Observational Study

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

Elena Arbelo et al. Eur Heart J. .
Free article

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.

Keywords: Ablation; Atrial fibrillation; Complications; Management; Outcomes; Prospective registry.

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