Current Status of Catheter Ablation for Atrial Fibrillation

Abstract

The purpose of this study was to provide precise data on the current status of catheter ablation for atrial fibrillation (AF) in Japan. The Japanese Heart Rhythm Society requested that members retrospectively register data for AF ablation performed in September 2011, March 2012, and September 2012. A total of 165 centers submitted data for 3,373 patients (age, 62±11 years; male, 76.1%; paroxysmal AF, 64.4%). Pulmonary vein isolation (PVI) and additional ablation were performed in 97.5% and 77.4% of patients, respectively. 3-D mapping systems and irrigated-tip catheters were used in 94.8% and 87.7% of the patients, respectively. Although the mean CHADS2 score was 1.0±1.0, the majority received oral anticoagulant (OAC) during and following the procedure (69.8% and 97%, respectively). Vitamin K antagonist (VKA) prescription, however, decreased (1st vs. 3rd survey, during and following the procedure, 59.3% vs. 47.8% and 81.7% vs. 55.2%, respectively, P<0.0001, both) and that of new OAC (NOAC) increased drastically (9.6% vs. 24.2% and 15.8% vs. 42.1%, respectively, P<0.0001). Early complications were reported in 4.5% of the patients, but no instance of early death was reported. In addition to PVI, additional ablation procedures are also performed very frequently. Although the mean CHADS2 score was low, peri-procedural OAC therapy was commonly performed, and NOAC drastically superseded VKA.