Catheter ablation for atrial fibrillation: Results from the first European registry

August 28, 2012

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 AFib. 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.

The findings were presented today at ESC Congress 2012 by Dr Elena Arbelo from Hospital Clínic de Barcelona, Spain, a co-investigator of the study.

"Atrial fibrillation is the most frequent and it represents a highly significant burden of disease and expenditure throughout the world," explained Dr Arbelo. "The currently available pharmacological therapies are not 100% effective, and they have secondary effects."

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

The AFib Ablation , the first registry to evaluate the day-to-day diagnostic and therapeutic processes of AFib ablation in Europe, 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 were presented ESC Congress 2011 and showed that two-thirds of patients having catheter ablation have paroxysmal AFib, and up to 40% have no apparent underlying cardiac disorder.(1)

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.
"The information obtained by the registry reflects everyday practice across Europe," said Dr Arbelo. "It is remarkable to see how most hospitals are evaluating the results of catheter ablation in a much more practical way than what is recommended for clinical trials, basing it mainly on periodical electrocardiograms and occasional Holter monitoring." She added that the results offer no clear definition how a successful procedure is defined - by abolition of symptoms or the absence of arrhythmias without antiarrhythmic drugs.

Commenting on the first-year information derived from the pilot registry, Dr Arbelo said: " is a major cardiovascular challenge in modern society and its medical and socioeconomic impact is expected to rise over the coming years. The AFib Ablation Registry provides an exceptional insight into the impact which may have in the management of with this arrhythmia."

Explore further: The first European registry to evaluate the real-life epidemiology of atrial fibrillation ablation

More information: 1. Arbelo E, Brugada J, Hindricks G, et al. ESC-EURObservational Research Programme: The Atrial Fibrillation Ablation Pilot Study, conducted by the European Heart Rhythm Association. Europace 2012; 14: 1094-1103.

Related Stories

The first European registry to evaluate the real-life epidemiology of atrial fibrillation ablation

August 30, 2011
Results presented today from the Atrial Fibrillation Ablation Pilot Study show that almost 40% of patients undergoing a catheter ablation for atrial fibrillation have no underlying disease associated with the arrhythmia, ...

Mount Sinai first to use visually guided catheter ablation system to treat AFib patient

February 21, 2012
For the first time in a new U.S. clinical trial, researchers at Mount Sinai School of Medicine have used the HeartLight Endoscopic Ablation System (EAS) to correct abnormal electrical signals inside the heart of a patient ...

Freeze and desist: Disabling cardiac cells that can cause arrhythmia

September 12, 2011
Many patients are responding to a new, minimally invasive way of treating irregular heartbeats by freezing out the bad cells. Atrial fibrillation (A-Fib) is one such heart rhythm disorder, and it's the most common arrhythmia ...

Recommended for you

Five vascular diseases linked to one common genetic variant

July 27, 2017
Genome-wide association studies have implicated a common genetic variant in chromosome 6p24 in coronary artery disease, as well as four other vascular diseases: migraine headache, cervical artery dissection, fibromuscular ...

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.