Catheter ablation for atrial fibrillation ( Afib ) is safe and suppresses arrhythmia recurrences in 74% of patients after a single procedure, according to results from the one-year follow-up of the Atrial Fibrillation Ablation Pilot Study, the first European registry to evaluate the real-life epidemiology of catheter ablation for atrial fibrillation.
The survey also showed that arrhythmia-related symptoms such as palpitations, shortness of breath, fatigue or dizziness, present in 86% of patients before the ablation, were significantly reduced.

Atrial fibrillation is the most frequent heart rhythm disorder; the currently available pharmacological therapies are not 100% effective, and they have secondary effects.

While symptoms remain the major reason for atrial fibrillation ablation, patients also welcome a drug-free life-style. The principal ablation strategy is the isolation of the pulmonary veins with additional linear and/or fragmented electrogram ablation in 10-20% of patients.

The AFib Ablation Pilot Study is a prospective, multicentre, 12-month observational study which recruited 1410 patients from 10 different European countries ( Belgium, Czech Republic, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Spain ).

Results from the in-hospital phase of the study showed that two-thirds of patients having catheter ablation have paroxysmal atrial fibrillation, and up to 40% have no apparent underlying cardiac disorder.

Now, results from the 12-month follow-up visit period provide further details of real-life outcomes:

Over the study period 77% of patients visited the clinic in person for review; however, at the 12-month follow-up 42% of the evaluations were by telephone;

Over half of the study population became asymptomatic after the ablation procedure ( symptoms were present in 90% of patients at baseline );

76% of patients had a periodical ECG to document arrhythmia recurrence, and only 50% of patients had Holter monitoring;

One-third of patients had a transthoracic echocardiogram during follow-up. Other tests such as cardiac CT or MRI were rare;

Almost 20% of patients had a second ablation procedure;

At 12 months around half of the study population were taking anticoagulants and 43% antiarrhythmic drugs. At discharge, 97% of patients had been prescribed anticoagulants and 67% antiarrhythmic medication;

The procedure was considered successful in 74% of patients, meaning no documented arrhythmias after a 3-month blanking period. However, just over 50% of patients were still taking antiarrhythmic drugs;

Complications during the first year after the ablation were infrequent ( 2.6% ), and mainly related to cerebrovascular events ( 0.54% ) or vascular injuries ( 0.71% ). There were four deaths: one secondary to hemorrhagic stroke, one for a non-cardiovascular cause and two of unknown origin.

Source: European Society of Cardiology ( ESC ) Meeting, 2012

XagenaMedicine2012