Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation

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

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1305 Scopus citations

Abstract

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 ≈80% of patients after 1.3 procedures per patient, with ≈70% of them not requiring further antiarrhythmic drugs during intermediate follow-up.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume3
Issue number1
DOIs
StatePublished - Feb 1 2010

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Keywords

  • Antiarrhythmic drugs
  • Atrial fibrillation
  • Catheter ablation
  • Follow-up studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Cappato, R., Calkins, H., Chen, S. A., Davies, W., Iesaka, Y., Kalman, J., Kim, Y. H., Klein, G., Natale, A., Packer, D., Skanes, A., Ambrogi, F., & Biganzoli, E. (2010). Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation: Arrhythmia and Electrophysiology, 3(1), 32-38. https://doi.org/10.1161/CIRCEP.109.859116