INTRODUCTION: Atrial fibrillation (AF) ablation is increasingly common, but is associated with potential major complications. Technology, experience, and protocols have evolved significantly in recent times, and may have impacted procedural safety. We sought to compare AF ablation safety profiles, including complication rates and fluoroscopy times in a "modern" versus "historical" cohort. METHODS AND RESULTS: We evaluated consecutive patients undergoing AF ablation from a modern cohort (MC) from 2014 to 2015 and a historic cohort (HC) from 2009 to 2011 for complications. Major complications were categorized according to Heart Rhythm Society guidelines. We included 1,425 patients, 726 in the HC and 699 in the MC. The MC was older, had more OSA and less valvular AF. Fifty-two (3.5%) procedures suffered major complications across the cohorts, with significantly fewer in the MC (5.0% vs. 2.3%, P = 0.007). The largest reductions were seen in vascular, hemorrhagic, ischemic stroke, and perforation/tamponade related complications. Periprocedural antiplatelets drugs (aHR 2.1 [95 CI 1.1-3.9], P = 0.02) and force-sensing catheters (aHR 0.4 [95 CI 0.2-0.9], P = 0.03) were independently related to major complication rates. Direct oral anticoagulants and uninterrupted anticoagulation were not associated with complications. There was a decrease in both fluoroscopy (-17.4 minutes [95 CI 19.2-15.6], P < 0.0001) and radiofrequency ablation times (-561 seconds [95CI -750 to -371], P < 0.0001). CONCLUSIONS: The safety profile of AF ablation has improved significantly in less than a decade.
INTRODUCTION:Atrial fibrillation (AF) ablation is increasingly common, but is associated with potential major complications. Technology, experience, and protocols have evolved significantly in recent times, and may have impacted procedural safety. We sought to compare AF ablation safety profiles, including complication rates and fluoroscopy times in a "modern" versus "historical" cohort. METHODS AND RESULTS: We evaluated consecutive patients undergoing AF ablation from a modern cohort (MC) from 2014 to 2015 and a historic cohort (HC) from 2009 to 2011 for complications. Major complications were categorized according to Heart Rhythm Society guidelines. We included 1,425 patients, 726 in the HC and 699 in the MC. The MC was older, had more OSA and less valvular AF. Fifty-two (3.5%) procedures suffered major complications across the cohorts, with significantly fewer in the MC (5.0% vs. 2.3%, P = 0.007). The largest reductions were seen in vascular, hemorrhagic, ischemic stroke, and perforation/tamponade related complications. Periprocedural antiplatelets drugs (aHR 2.1 [95 CI 1.1-3.9], P = 0.02) and force-sensing catheters (aHR 0.4 [95 CI 0.2-0.9], P = 0.03) were independently related to major complication rates. Direct oral anticoagulants and uninterrupted anticoagulation were not associated with complications. There was a decrease in both fluoroscopy (-17.4 minutes [95 CI 19.2-15.6], P < 0.0001) and radiofrequency ablation times (-561 seconds [95CI -750 to -371], P < 0.0001). CONCLUSIONS: The safety profile of AF ablation has improved significantly in less than a decade.
Authors: Valter Giaretto; Andrea Ballatore; Claudio Passerone; Paolo Desalvo; Mario Matta; Andrea Saglietto; Mario De Salve; Fiorenzo Gaita; Bruno Panella; Matteo Anselmino Journal: J R Soc Interface Date: 2019-09-18 Impact factor: 4.118
Authors: Zak Loring; DaJuanicia N Holmes; Roland A Matsouaka; Anne B Curtis; John D Day; Nihar Desai; Kenneth A Ellenbogen; Gregory K Feld; Gregg C Fonarow; David S Frankel; Jodie L Hurwitz; Bradley P Knight; Jose A Joglar; Andrea M Russo; Mandeep S Sidhu; Mintu P Turakhia; William R Lewis; Jonathan P Piccini Journal: Circ Arrhythm Electrophysiol Date: 2020-07-23
Authors: Malte Kuniss; Nikola Pavlovic; Vedran Velagic; Jean Sylvain Hermida; Stewart Healey; Giuseppe Arena; Nicolas Badenco; Christian Meyer; Jian Chen; Saverio Iacopino; Frédéric Anselme; Douglas L Packer; Heinz-Friedrich Pitschner; Carlo de Asmundis; Stephan Willems; Fabio Di Piazza; Daniel Becker; Gian-Battista Chierchia Journal: Europace Date: 2021-07-18 Impact factor: 5.214
Authors: Fredrik Holmqvist; Milos Kesek; Anders Englund; Carina Blomström-Lundqvist; Lars O Karlsson; Göran Kennebäck; Dritan Poçi; Romeo Samo-Ayou; Runa Sigurjónsdóttir; Michael Ringborn; Csaba Herczku; Jonas Carlson; Espen Fengsrud; Fariborz Tabrizi; Niklas Höglund; Stefan Lönnerholm; Ole Kongstad; Anders Jönsson; Per Insulander Journal: Eur Heart J Date: 2019-03-07 Impact factor: 29.983