Abstract
Aims: Clinical trials have established that atrial fibrillation (AF) catheter ablation improves symptoms in appropriately selected patients. Confirmation of these results by long-term prospective observational studies is needed. This registry was created to describe the experience of 16 Italian centers with a large cohort of AF patients treated with catheter ablation guided by the NavX 3D mapping system. Methods: From November 2006 to May 2008, 545 consecutive patients (age 60.4 ± 9.8, 67 % male) with paroxysmal (44 %), persistent (43 %), and long-standing persistent (13 %) AF referred for catheter ablation guided by the NavX system, were included in this registry. For this paper, follow-up was censored at 24 months; however, patients are being followed in the ongoing registry. Results: Before the ablation, 80 % of patients failed to respond to at least one antiarrhythmic drug aimed at rhythm control. Pulmonary vein (PV) isolation guided by a circular mapping catheter was performed in 70 % of patients whereas non potential-guided PV encircling was performed in 30 % of patients. In 67 % of patients, additional left atrial (LA) substrate modification was performed. Image integration was performed in 9.2 % of patients. Considering a 3-month blanking period, after a single-ablation procedure, the patients had 1- and 2-year freedom from AF recurrence of 67.4 and 57.0 % (36.1 % off antiarrhythmic drugs), respectively. Cox regression analysis showed that AF recurrences during blanking (HR 2.1), and previous AF ablation (HR 3.3) were independent predictors of AF recurrences. Major procedure-related complications occurred in 53 patients (9.7 %). In 35 patients (6.7 %), a repeat procedure was performed at a median of 5 months after the initial procedure. Conclusions: This prospective, multicenter clinical experience provides significant insights into current ablation care of patients with AF. Despite favorable outcomes, real-world complication rates appear higher than previously recognized.
| Original language | English |
|---|---|
| Pages (from-to) | 87-95 |
| Number of pages | 9 |
| Journal | Journal of Interventional Cardiac Electrophysiology |
| Volume | 37 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jun 2013 |
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Keywords
- 3D mapping
- Atrial fibrillation
- Catheter ablation
- Image integration
- Long-term outcomes
- Survey
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Catheter ablation of atrial fibrillation guided by a 3D electroanatomical mapping system : A 2-year follow-up study from the Italian Registry on NavX Atrial Fibrillation ablation procedures (IRON-AF). / Forleo, Giovanni B.; De Martino, Giuseppe; Mantica, Massimo; Menardi, Endrj; Trevisi, Nicola; Faustino, Massimiliano; Muto, Carmine; Perna, Francesco; Santamaria, Matteo; Pandozi, Claudio; Pappalardo, Augusto; Mancusi, Carmine; Romano, Enrico; Della Bella, Paolo; Tondo, Claudio.
In: Journal of Interventional Cardiac Electrophysiology, Vol. 37, No. 1, 06.2013, p. 87-95.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Catheter ablation of atrial fibrillation guided by a 3D electroanatomical mapping system
T2 - A 2-year follow-up study from the Italian Registry on NavX Atrial Fibrillation ablation procedures (IRON-AF)
AU - Forleo, Giovanni B.
AU - De Martino, Giuseppe
AU - Mantica, Massimo
AU - Menardi, Endrj
AU - Trevisi, Nicola
AU - Faustino, Massimiliano
AU - Muto, Carmine
AU - Perna, Francesco
AU - Santamaria, Matteo
AU - Pandozi, Claudio
AU - Pappalardo, Augusto
AU - Mancusi, Carmine
AU - Romano, Enrico
AU - Della Bella, Paolo
AU - Tondo, Claudio
PY - 2013/6
Y1 - 2013/6
N2 - Aims: Clinical trials have established that atrial fibrillation (AF) catheter ablation improves symptoms in appropriately selected patients. Confirmation of these results by long-term prospective observational studies is needed. This registry was created to describe the experience of 16 Italian centers with a large cohort of AF patients treated with catheter ablation guided by the NavX 3D mapping system. Methods: From November 2006 to May 2008, 545 consecutive patients (age 60.4 ± 9.8, 67 % male) with paroxysmal (44 %), persistent (43 %), and long-standing persistent (13 %) AF referred for catheter ablation guided by the NavX system, were included in this registry. For this paper, follow-up was censored at 24 months; however, patients are being followed in the ongoing registry. Results: Before the ablation, 80 % of patients failed to respond to at least one antiarrhythmic drug aimed at rhythm control. Pulmonary vein (PV) isolation guided by a circular mapping catheter was performed in 70 % of patients whereas non potential-guided PV encircling was performed in 30 % of patients. In 67 % of patients, additional left atrial (LA) substrate modification was performed. Image integration was performed in 9.2 % of patients. Considering a 3-month blanking period, after a single-ablation procedure, the patients had 1- and 2-year freedom from AF recurrence of 67.4 and 57.0 % (36.1 % off antiarrhythmic drugs), respectively. Cox regression analysis showed that AF recurrences during blanking (HR 2.1), and previous AF ablation (HR 3.3) were independent predictors of AF recurrences. Major procedure-related complications occurred in 53 patients (9.7 %). In 35 patients (6.7 %), a repeat procedure was performed at a median of 5 months after the initial procedure. Conclusions: This prospective, multicenter clinical experience provides significant insights into current ablation care of patients with AF. Despite favorable outcomes, real-world complication rates appear higher than previously recognized.
AB - Aims: Clinical trials have established that atrial fibrillation (AF) catheter ablation improves symptoms in appropriately selected patients. Confirmation of these results by long-term prospective observational studies is needed. This registry was created to describe the experience of 16 Italian centers with a large cohort of AF patients treated with catheter ablation guided by the NavX 3D mapping system. Methods: From November 2006 to May 2008, 545 consecutive patients (age 60.4 ± 9.8, 67 % male) with paroxysmal (44 %), persistent (43 %), and long-standing persistent (13 %) AF referred for catheter ablation guided by the NavX system, were included in this registry. For this paper, follow-up was censored at 24 months; however, patients are being followed in the ongoing registry. Results: Before the ablation, 80 % of patients failed to respond to at least one antiarrhythmic drug aimed at rhythm control. Pulmonary vein (PV) isolation guided by a circular mapping catheter was performed in 70 % of patients whereas non potential-guided PV encircling was performed in 30 % of patients. In 67 % of patients, additional left atrial (LA) substrate modification was performed. Image integration was performed in 9.2 % of patients. Considering a 3-month blanking period, after a single-ablation procedure, the patients had 1- and 2-year freedom from AF recurrence of 67.4 and 57.0 % (36.1 % off antiarrhythmic drugs), respectively. Cox regression analysis showed that AF recurrences during blanking (HR 2.1), and previous AF ablation (HR 3.3) were independent predictors of AF recurrences. Major procedure-related complications occurred in 53 patients (9.7 %). In 35 patients (6.7 %), a repeat procedure was performed at a median of 5 months after the initial procedure. Conclusions: This prospective, multicenter clinical experience provides significant insights into current ablation care of patients with AF. Despite favorable outcomes, real-world complication rates appear higher than previously recognized.
KW - 3D mapping
KW - Atrial fibrillation
KW - Catheter ablation
KW - Image integration
KW - Long-term outcomes
KW - Survey
UR - http://www.scopus.com/inward/record.url?scp=84877575247&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877575247&partnerID=8YFLogxK
U2 - 10.1007/s10840-012-9772-4
DO - 10.1007/s10840-012-9772-4
M3 - Article
C2 - 23397247
AN - SCOPUS:84877575247
VL - 37
SP - 87
EP - 95
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
SN - 1383-875X
IS - 1
ER -