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

Aamir Cheema, Chandrasekhar R. Vasamreddy, Darshan Dalal, Joseph E. Marine, Jun Dong, Charles Henrikson, David Spragg, Alan Cheng, Saman Nazarian, Sunil Sinha, Henry Halperin, Ronald Berger, Hugh Calkins

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Background: Two important limitations of the data regarding the outcomes of catheter ablation of atrial fibrillation (AF) are the short-term follow-up used in most published studies and the lack of single-procedure outcomes. Objective: The objective was to report the long-term single-procedure outcomes at our center. Materials and methods: The patient population was comprised of 200 consecutive patients who underwent ablation (133 men; age 56 ± 11 years). Atrial fibrillation was paroxysmal in 92 (46%). Success was defined as absence of symptomatic AF, off antiarrhythmic drug (AAD) after a single procedure. Results: After a follow-up of 26 ± 11 months, the single-procedure long-term success rate was 28% with an additional 7% of patients demonstrating improvement. After including repeat procedures in 64 patients, the overall long-term success rate was 41% with 11% demonstrating improvement. Further subgroup analysis of 48 paroxysmal AF patients considered to be optimal candidates for the procedure, revealed a long-term success rate of 69% with an additional 4% demonstrating improvement. A major complication occurred in 7.9% of patients. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)145-155
Number of pages11
JournalJournal of Interventional Cardiac Electrophysiology
Volume15
Issue number3
DOIs
StatePublished - Apr 2006
Externally publishedYes

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Catheter Ablation
Atrial Fibrillation
Anti-Arrhythmia Agents
Population
Research Personnel

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term single procedure efficacy of catheter ablation of atrial fibrillation. / Cheema, Aamir; Vasamreddy, Chandrasekhar R.; Dalal, Darshan; Marine, Joseph E.; Dong, Jun; Henrikson, Charles; Spragg, David; Cheng, Alan; Nazarian, Saman; Sinha, Sunil; Halperin, Henry; Berger, Ronald; Calkins, Hugh.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 15, No. 3, 04.2006, p. 145-155.

Research output: Contribution to journalArticle

Cheema, A, Vasamreddy, CR, Dalal, D, Marine, JE, Dong, J, Henrikson, C, Spragg, D, Cheng, A, Nazarian, S, Sinha, S, Halperin, H, Berger, R & Calkins, H 2006, 'Long-term single procedure efficacy of catheter ablation of atrial fibrillation', Journal of Interventional Cardiac Electrophysiology, vol. 15, no. 3, pp. 145-155. https://doi.org/10.1007/s10840-006-9005-9
Cheema, Aamir ; Vasamreddy, Chandrasekhar R. ; Dalal, Darshan ; Marine, Joseph E. ; Dong, Jun ; Henrikson, Charles ; Spragg, David ; Cheng, Alan ; Nazarian, Saman ; Sinha, Sunil ; Halperin, Henry ; Berger, Ronald ; Calkins, Hugh. / Long-term single procedure efficacy of catheter ablation of atrial fibrillation. In: Journal of Interventional Cardiac Electrophysiology. 2006 ; Vol. 15, No. 3. pp. 145-155.
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T1 - Long-term single procedure efficacy of catheter ablation of atrial fibrillation

AU - Cheema, Aamir

AU - Vasamreddy, Chandrasekhar R.

AU - Dalal, Darshan

AU - Marine, Joseph E.

AU - Dong, Jun

AU - Henrikson, Charles

AU - Spragg, David

AU - Cheng, Alan

AU - Nazarian, Saman

AU - Sinha, Sunil

AU - Halperin, Henry

AU - Berger, Ronald

AU - Calkins, Hugh

PY - 2006/4

Y1 - 2006/4

N2 - Background: Two important limitations of the data regarding the outcomes of catheter ablation of atrial fibrillation (AF) are the short-term follow-up used in most published studies and the lack of single-procedure outcomes. Objective: The objective was to report the long-term single-procedure outcomes at our center. Materials and methods: The patient population was comprised of 200 consecutive patients who underwent ablation (133 men; age 56 ± 11 years). Atrial fibrillation was paroxysmal in 92 (46%). Success was defined as absence of symptomatic AF, off antiarrhythmic drug (AAD) after a single procedure. Results: After a follow-up of 26 ± 11 months, the single-procedure long-term success rate was 28% with an additional 7% of patients demonstrating improvement. After including repeat procedures in 64 patients, the overall long-term success rate was 41% with 11% demonstrating improvement. Further subgroup analysis of 48 paroxysmal AF patients considered to be optimal candidates for the procedure, revealed a long-term success rate of 69% with an additional 4% demonstrating improvement. A major complication occurred in 7.9% of patients. Conclusion: 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.

AB - Background: Two important limitations of the data regarding the outcomes of catheter ablation of atrial fibrillation (AF) are the short-term follow-up used in most published studies and the lack of single-procedure outcomes. Objective: The objective was to report the long-term single-procedure outcomes at our center. Materials and methods: The patient population was comprised of 200 consecutive patients who underwent ablation (133 men; age 56 ± 11 years). Atrial fibrillation was paroxysmal in 92 (46%). Success was defined as absence of symptomatic AF, off antiarrhythmic drug (AAD) after a single procedure. Results: After a follow-up of 26 ± 11 months, the single-procedure long-term success rate was 28% with an additional 7% of patients demonstrating improvement. After including repeat procedures in 64 patients, the overall long-term success rate was 41% with 11% demonstrating improvement. Further subgroup analysis of 48 paroxysmal AF patients considered to be optimal candidates for the procedure, revealed a long-term success rate of 69% with an additional 4% demonstrating improvement. A major complication occurred in 7.9% of patients. Conclusion: 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.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Pulmonary vein

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