Long-term single procedure efficacy of catheter ablation of atrial fibrillation

Abstract

The results reveal that the long-term single-procedure success rate of catheter ablation of AF in a cohort of patients with predominantly non-paroxysmal AF is less than 40%. The inclusion of redo procedures resulted in an improvement in outcomes. A much higher success rate of 69% was achieved in patients with paroxysmal AF considered to be optimal candidates for this procedure. These results make it clear that further advances in the technique of catheter ablation of AF are needed to improve the safety and efficacy of this procedure. In order to be able to compare outcomes of various techniques in differing patient populations, we urge investigators to report long-term single procedure outcomes.

Ablação por radiofreqüência da fibrilação atrial paroxística: fatores determinantes da eficácia clínica a longo-prazo

“…In addition, some of these studies 7,12 consider success rates not only after one procedure, but summing up the positive results obtained after repeated interventions. Like in Cheema et al 20 study, in the present study the success rates were obtained considering only one single procedure, which may also have contributed to a lower success rate.…”

“…Della Bella et al 19 showed a success rate similar to ours, considering a 12-month follow-up period (65% versus 67%, respectively). Recently, Cheema et al 12,20 and Lee et al 21 presented their results based on longer follow-up periods that ranged from 11 to 30 months, achieving success rates no higher than 69% in this circumstance. In addition, some of these studies 7,12 consider success rates not only after one procedure, but summing up the positive results obtained after repeated interventions.…”

Clinical Outcome of Electrophysiologically Guided Ablation for Nonparoxysmal Atrial Fibrillation Using a Novel Real-Time 3-Dimensional Mapping Technique

“…1 However, the high efficacy of this procedure in paroxysmal AF is counterbalanced by suboptimal clinical results when dealing with the persistent form; for this reason, the treatment strategy in this subset of patients is still under debate. [2][3][4] In fact, our incomplete understanding of the AF mechanisms has led to a wide range of approaches targeting atrial substrate in addition to pulmonary vein (PV) isolation. 5 Recent clinical studies have demonstrated that AF in humans could be sustained by regular and organized sources and that radiofrequency catheter ablation targeting the regions showing highest dominant frequency or eliminating electric rotors resulted in high rates of acute AF termination and improved long-term clinical outcome.…”

Ablação por radiofreqüência da fibrilação atrial paroxística: fatores determinantes da eficácia clínica a longo prazo

“…Recentemente, Cheema e cols. 12,20 e Lee e cols. 21 apresentaram seus resultados baseados em tempos de seguimento maiores, que variaram de 11 a 30 meses, e nessa circunstância alcançaram taxas de sucesso não superiores a 69%.…”

“…Assim como no trabalho de Cheema e cols. 20 , no presente trabalho as taxas de sucesso foram obtidas considerando-se somente um único procedimento, o que também possivelmente tenha contribuído para uma porcentagem menor de sucesso.…”