BACKGROUND: A nationwide survey of catheter ablation for atrial fibrillation (AF) was conducted in Japan to determine the mid-term performance of the therapy from analysis of the 1-year outcome of registered patients. METHODS AND RESULTS: A total of 2,137 patients who underwent AF ablation in September 2011 and March 2012 were initially registered. In 2013, the 1-year follow-up data of 1,208 patients (56.5% of 2,137) from 119 centers were collected. Average age was 61.9±10.7 years. Patients with paroxysmal AF (PAF) constituted 64.3%. Persistent AF (pAF) and long-standing pAF (LS-pAF) were 20.4% and 15.3%, respectively. For all patients, 76.7% underwent their first AF ablation. At 1 year after AF ablation, 70.9%, 61.4%, and 56.2% of PAF, pAF, and LS-pAF patients, respectively, were free from AF or clinical/partial success (PAF vs. pAF or LS-pAF: P<0.01). Re-ablation was performed in 11.3%, 16.3%, and 17.3%, respectively. Multivariate logistic regression analysis revealed that procedure time (odds ratio [OR] 0.82, P=0.000), and results of AF induction test (OR 1.36, P<0.02) were significantly related to successful outcome. CONCLUSIONS: Approximately 70% of PAF and 60% of nonPAF patients were free from AF recurrence or had clinical/partial success status. Shorter procedure time and elimination of AF inducibility were independent predictors of mid-term success of AF ablation.
BACKGROUND: A nationwide survey of catheter ablation for atrial fibrillation (AF) was conducted in Japan to determine the mid-term performance of the therapy from analysis of the 1-year outcome of registered patients. METHODS AND RESULTS: A total of 2,137 patients who underwent AF ablation in September 2011 and March 2012 were initially registered. In 2013, the 1-year follow-up data of 1,208 patients (56.5% of 2,137) from 119 centers were collected. Average age was 61.9±10.7 years. Patients with paroxysmal AF (PAF) constituted 64.3%. Persistent AF (pAF) and long-standing pAF (LS-pAF) were 20.4% and 15.3%, respectively. For all patients, 76.7% underwent their first AF ablation. At 1 year after AF ablation, 70.9%, 61.4%, and 56.2% of PAF, pAF, and LS-pAFpatients, respectively, were free from AF or clinical/partial success (PAF vs. pAF or LS-pAF: P<0.01). Re-ablation was performed in 11.3%, 16.3%, and 17.3%, respectively. Multivariate logistic regression analysis revealed that procedure time (odds ratio [OR] 0.82, P=0.000), and results of AF induction test (OR 1.36, P<0.02) were significantly related to successful outcome. CONCLUSIONS: Approximately 70% of PAF and 60% of nonPAF patients were free from AF recurrence or had clinical/partial success status. Shorter procedure time and elimination of AF inducibility were independent predictors of mid-term success of AF ablation.
Authors: Mate Vamos; Riccardo Cappato; Francis E Marchlinski; Andrea Natale; Stefan H Hohnloser Journal: Europace Date: 2016-01-20 Impact factor: 5.214