Catheter ablation for atrial fibrillation—Single center experience

Abstract

AimsCatheter ablation (CA) has become standard therapy for atrial fibrillation, especially for paroxysmal atrial fibrillation. Precise single center follow-up (FU) data (especially long-term FU data) are published infrequently. MethodsWe studied 303 consecutive patients (172 males, 131 females, mean age 57 years) who underwent catheter ablation for atrial fibrillation (489 procedures) in years 2004–2012. Clinical examination, ECG, 24-h or 7-day Holter monitoring and quality of life (QoL) measurement (EQ-5D) was performed at 3, 6, 12, 18 and 24-month FU. ResultsFU data longer than 6 month after the first procedure are available for 135 patients with paroxysmal, 84 patients with persistent and 48 patients with longstanding persistent AF. The success rate after 6 month after the first procedure (sinus rhythm without AA drugs, no arrhythmias) was 48% for paroxysmal, 43% for persistent and 44% for longstanding persistent AF. The complication rate was 3.3% (16 patients, no deaths, no pulmonary vein stenosis, 5 incidents of pericardial effusion treated with pericardiocentesis; 1 transitory ischemic attack; the remainder were local complications in the groin). The success rate after the last procedure (mean FU 24±16 month, 1.6 procedure per patient) was 80% for paroxysmal and 58% for persistent and longstanding persistent AF. QoL increased significantly in all groups of patients. ConclusionWith the standard procedure we can achieve acceptable results (success rate 60–80% with repeated procedures) with low complication rate even in a “lower volume” center. In selected patients (with paroxysmal AF preferring interventional treatment) can be CA recommended as first-line therapy for rhythm control. CA improves QoL in our patients with AF. As there is no gold standard to measure QoL in AF patients, EQ-5D seems to be a simple, quick and useful tool.