Prospective European survey on atrial fibrillation ablation

Clinical characteristics of patients and ablation strategies used in different countries

Sakis Themistoclakis, Antonio Raviele, Paolo China, Carlo Pappone, Roberto De Ponti, Amiran Revishvili, Etienne Aliot, Karl Heinz Kuck, Per Ivar Hoff, Dipen Shah, Jesús Almendral, Antonis S. Manolis, Gian Battista Chierchia, Ali Oto, Radu G. Vatasescu, Matjaz Sinkovec, Riccardo Cappato

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Survey on Atrial Fibrillation Ablation Background Atrial fibrillation (AF) ablation is widely adopted. Our aim was to conduct a prospective multicenter survey to verify patients' characteristics, approaches, and technologies adopted across Europe. Methods and Results A total of 35 centers in 12 countries actively participated in the study and 940 patients (median age 60 years) were enrolled. AF was paroxysmal, persistent, and long-lasting persistent in 52.4%, 36%, and 11.6% of patients, respectively; 95.5% of patients were symptomatic and 91.4% were refractory to antiarrhythmic therapy. Redo procedures were performed in 20.9%. Pulmonary vein isolation (PVI) emerged as the cornerstone of ablative therapy and has been performed in 98.7% of procedures, with confirmation of PVI in 92.9% of cases. The ablation of nonparoxysmal AF was not generally limited to isolating the PVs and several adjunctive approaches are adopted, particularly in the case of long-lasting persistent AF. Linear lesions or elimination of complex fractionated atrial electrograms were more frequently added. Circular mapping catheters and imaging techniques were seen to be used in about two-thirds of cases. Radiofrequency energy was delivered through open irrigated catheters in 68% of cases. Conclusions European centers are largely following the recommendations of the guidelines and the expert consensus documents for AF ablation. AF ablation is mainly performed in relatively young patients with symptomatic drug refractory AF and no or minimal heart disease. Patients with paroxysmal AF are the most frequently treated with a quite uniform ablative approach across Europe. A less standardized approach was observed in nonparoxysmal AF patients.

Original languageEnglish
Pages (from-to)1074-1081
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 1 2014

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Atrial Fibrillation
Pulmonary Veins
Catheters
Surveys and Questionnaires
Cardiac Electrophysiologic Techniques
Heart Diseases
Guidelines
Technology
Therapeutics
Pharmaceutical Preparations

Keywords

  • atrial fibrillation
  • catheter ablation
  • survey

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Prospective European survey on atrial fibrillation ablation : Clinical characteristics of patients and ablation strategies used in different countries. / Themistoclakis, Sakis; Raviele, Antonio; China, Paolo; Pappone, Carlo; Ponti, Roberto De; Revishvili, Amiran; Aliot, Etienne; Kuck, Karl Heinz; Hoff, Per Ivar; Shah, Dipen; Almendral, Jesús; Manolis, Antonis S.; Chierchia, Gian Battista; Oto, Ali; Vatasescu, Radu G.; Sinkovec, Matjaz; Cappato, Riccardo.

In: Journal of Cardiovascular Electrophysiology, Vol. 25, No. 10, 01.10.2014, p. 1074-1081.

Research output: Contribution to journalArticle

Themistoclakis, S, Raviele, A, China, P, Pappone, C, Ponti, RD, Revishvili, A, Aliot, E, Kuck, KH, Hoff, PI, Shah, D, Almendral, J, Manolis, AS, Chierchia, GB, Oto, A, Vatasescu, RG, Sinkovec, M & Cappato, R 2014, 'Prospective European survey on atrial fibrillation ablation: Clinical characteristics of patients and ablation strategies used in different countries', Journal of Cardiovascular Electrophysiology, vol. 25, no. 10, pp. 1074-1081. https://doi.org/10.1111/jce.12462
Themistoclakis, Sakis ; Raviele, Antonio ; China, Paolo ; Pappone, Carlo ; Ponti, Roberto De ; Revishvili, Amiran ; Aliot, Etienne ; Kuck, Karl Heinz ; Hoff, Per Ivar ; Shah, Dipen ; Almendral, Jesús ; Manolis, Antonis S. ; Chierchia, Gian Battista ; Oto, Ali ; Vatasescu, Radu G. ; Sinkovec, Matjaz ; Cappato, Riccardo. / Prospective European survey on atrial fibrillation ablation : Clinical characteristics of patients and ablation strategies used in different countries. In: Journal of Cardiovascular Electrophysiology. 2014 ; Vol. 25, No. 10. pp. 1074-1081.
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abstract = "Survey on Atrial Fibrillation Ablation Background Atrial fibrillation (AF) ablation is widely adopted. Our aim was to conduct a prospective multicenter survey to verify patients' characteristics, approaches, and technologies adopted across Europe. Methods and Results A total of 35 centers in 12 countries actively participated in the study and 940 patients (median age 60 years) were enrolled. AF was paroxysmal, persistent, and long-lasting persistent in 52.4{\%}, 36{\%}, and 11.6{\%} of patients, respectively; 95.5{\%} of patients were symptomatic and 91.4{\%} were refractory to antiarrhythmic therapy. Redo procedures were performed in 20.9{\%}. Pulmonary vein isolation (PVI) emerged as the cornerstone of ablative therapy and has been performed in 98.7{\%} of procedures, with confirmation of PVI in 92.9{\%} of cases. The ablation of nonparoxysmal AF was not generally limited to isolating the PVs and several adjunctive approaches are adopted, particularly in the case of long-lasting persistent AF. Linear lesions or elimination of complex fractionated atrial electrograms were more frequently added. Circular mapping catheters and imaging techniques were seen to be used in about two-thirds of cases. Radiofrequency energy was delivered through open irrigated catheters in 68{\%} of cases. Conclusions European centers are largely following the recommendations of the guidelines and the expert consensus documents for AF ablation. AF ablation is mainly performed in relatively young patients with symptomatic drug refractory AF and no or minimal heart disease. Patients with paroxysmal AF are the most frequently treated with a quite uniform ablative approach across Europe. A less standardized approach was observed in nonparoxysmal AF patients.",
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AU - Themistoclakis, Sakis

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AU - Pappone, Carlo

AU - Ponti, Roberto De

AU - Revishvili, Amiran

AU - Aliot, Etienne

AU - Kuck, Karl Heinz

AU - Hoff, Per Ivar

AU - Shah, Dipen

AU - Almendral, Jesús

AU - Manolis, Antonis S.

AU - Chierchia, Gian Battista

AU - Oto, Ali

AU - Vatasescu, Radu G.

AU - Sinkovec, Matjaz

AU - Cappato, Riccardo

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N2 - Survey on Atrial Fibrillation Ablation Background Atrial fibrillation (AF) ablation is widely adopted. Our aim was to conduct a prospective multicenter survey to verify patients' characteristics, approaches, and technologies adopted across Europe. Methods and Results A total of 35 centers in 12 countries actively participated in the study and 940 patients (median age 60 years) were enrolled. AF was paroxysmal, persistent, and long-lasting persistent in 52.4%, 36%, and 11.6% of patients, respectively; 95.5% of patients were symptomatic and 91.4% were refractory to antiarrhythmic therapy. Redo procedures were performed in 20.9%. Pulmonary vein isolation (PVI) emerged as the cornerstone of ablative therapy and has been performed in 98.7% of procedures, with confirmation of PVI in 92.9% of cases. The ablation of nonparoxysmal AF was not generally limited to isolating the PVs and several adjunctive approaches are adopted, particularly in the case of long-lasting persistent AF. Linear lesions or elimination of complex fractionated atrial electrograms were more frequently added. Circular mapping catheters and imaging techniques were seen to be used in about two-thirds of cases. Radiofrequency energy was delivered through open irrigated catheters in 68% of cases. Conclusions European centers are largely following the recommendations of the guidelines and the expert consensus documents for AF ablation. AF ablation is mainly performed in relatively young patients with symptomatic drug refractory AF and no or minimal heart disease. Patients with paroxysmal AF are the most frequently treated with a quite uniform ablative approach across Europe. A less standardized approach was observed in nonparoxysmal AF patients.

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