Number Of Catheter Ablation Procedures Research Articles

Catheter ablation in adults with congenital heart disease: A 15-year perspective from a tertiary centre

With the growing adult congenital heart disease (ACHD) population, the number of catheter ablation procedures is expected to dramatically increase. Data reporting experience and evolution of catheter ablation in patients with ACHD, over a significant period of time, remain scarce. We aimed to describe temporal trends in volume and outcomes of catheter ablation in patients with ACHD. This was a retrospective observational study including all consecutive patients with ACHD undergoing attempted catheter ablation in a large tertiary referral centre over a 15-year period. Acute procedural success rate and freedom from recurrence at 12 and 24 months were analysed. From November 2004 to November 2019, 302 catheter ablations were performed in 221 patients with ACHD (mean age 43.6±15.0 years; 58.9% male sex). The annual number of catheter ablations increased progressively from four to 60 cases per year (P<0.001). Intra-atrial reentrant tachycardia/focal atrial tachycardia was the most common arrhythmia (n=217, 71.9%). Over the study period, acute procedural success rate increased from 45.0% to 93.4% (P<0.001). Use of irrigated catheters (odds ratio [OR] 4.03, 95% confidence interval [CI] 1.86-8.55), a three-dimensional mapping system (OR 3.70, 95% CI 1.72-7.74), contact force catheters (OR 3.60, 95% CI 1.81-7.38) and high-density mapping (OR 3.69, 95% CI 1.82-8.14) were associated with acute procedural success. The rate of freedom from any recurrence at 12 months increased from 29.4% to 66.2% (P=0.001). Seven (2.3%) non-fatal complications occurred. The number of catheter ablation procedures in patients with ACHD has increased considerably over the past 15 years. Growing experience and advances in ablative technologies appear to be associated with a significant improvement in acute and mid-term outcomes.

Catheter ablation in adults with congenital heart disease: A 15-year perspective form a tertiary center

With the growing adult congenital heart disease (ACHD) population, the number of catheter ablation procedures is expected to dramatically increase. Data reporting experience and evolution of catheter ablation in ACHD patients, over a significant period of time, remain scarce. We aimed to describe temporal trends in volume and outcomes of catheter ablation in ACHD patients. Retrospective observational study including all consecutive ACHD patients undergoing attempted catheter ablation in a large tertiary referral center over a 15-year period. Acute procedural success rate and freedom from recurrence at 12 months were analyzed. From November 2004 to November 2019, 302 catheter ablations in 221 ACHD patients (43.6 ± 15.0 years, 58.9% males) were performed. The annual number of catheter ablation increased progressively from 4 to 60 cases per year ( P < 0.001). Intra-atrial reentrant tachycardia/focal atrial tachycardia was the most common arrhythmia ( n = 217, 71.9%). Over the study period, acute procedural success rate increased from 45.0% to 93.4% ( P < 0.001). Use of irrigated catheters (OR = 4.03, 95% CI: 1.86–8.55), 3D-mapping system (OR = 3.70, 95% CI: 1.72–7.74), contact force catheters (OR = 3.60, 95% CI: 1.81–7.38), and high-density mapping (OR = 3.69, 95% CI: 1.82–8.14) were associated with acute procedural success. The rate of freedom from any recurrence at 12 months increased from 29.4% to 66.2% ( P = 0.001). Seven (2.3%) non-fatal complications occurred ( Fig. 1 ). The number of catheter ablation procedures in ACHD patients has considerably increased over the last 15 years. Growing experience and advances in ablative technologies appear to be associated with a significant improvement in acute and midterm outcomes.

Catheter ablation in adults with congenital heart disease: a 15-year perspective from a tertiary center

Abstract Background With the growing population of adults with congenital heart disease (ACHD), the number of catheter ablation procedures is expected to increase over time. Purpose We aimed to describe temporal trends in volume and outcomes of catheter ablation procedures in ACHD patients in a large tertiary center. Methods Retrospective observational study including all consecutive ACHD patients undergoing catheter ablation in a tertiary reference center over a 15-year period. Acute procedural success rate (including complete success in case of non-inducibility of any arrhythmia at the end of the procedure) as well as freedom from recurrence at 12 months were analyzed. Results From November 2004 to November 2019, 302 catheter ablations in 221 ACHD patients (43.6±15.0 years, 58.9% males) were performed. The annual number of catheter ablation increased progressively from 4 to 60 by year (p&amp;lt;0.001). Intra-atrial reentrant tachycardia/focal atrial tachycardia was the most common targeted arrhythmia (n=217, 71.9%). Over the study period, acute procedural success rate increased from 45.0% to 93.3% (p&amp;lt;0.001), including complete acute procedural success from 45.0% to 88.1% (p&amp;lt;0.001) (Figure 1). The use of irrigated catheters (30.0% to 94.8%, p&amp;lt;0.001), 3D-mapping systems (60.0% to 96.3%, p&amp;lt;0.001), contact force catheters (0.0% to 91.9%, &amp;lt;0.001), and high-density mapping (0.0% to 71.9%, p&amp;lt;0.01) increased significantly. Use of irrigated catheters (OR=3.96, 95% CI: 1.79–8.55), 3D-mapping system (OR=3.55, 95% CI: 1.62–7.55), contact force catheters (OR=3.46, 95% CI: 1.71–7.25), and high-density mapping (OR=3.85, 95% CI: 1.60–7.26) were associated with acute procedural success. The rate of freedom from any recurrence at 12 months increased from 29.4% to 66.2% (p=0.001). Seven (2.3%) non-fatal complications occurred. Conclusions The number of catheter ablation procedures in ACHD patients has considerably increased over the last 15 years. Advances in ablative technologies appear to be associated with a low rate of complications and a significant improvement in acute and midterm outcomes. Evolution of acute procedural success Funding Acknowledgement Type of funding source: None

Comparison of health-related quality of life in patients with atrial fibrillation treated with catheter ablation or antiarrhythmic drug therapy: a systematic review and meta-analysis protocol

IntroductionAtrial fibrillation (AF) is the most prevalent cardiac arrhythmia and causes patients considerable burden; symptoms such as palpitations and dyspnoea are common, leading to frequent emergency room visits. Patients with...

National Registry of Catheter Ablation 2010

Background Catheter ablation of arrhythmogenic substrates and circuitsis a common procedure in current medical practice. The NationalRegistry of Catheter Ablation 2010 was carried out incardiac electrophysiology centers from the Autonomous Cityof Buenos Aires and from Argentine provinces; it was coordinatedby members of the Committees of Arrhythmias of the Argentine Society of Cardiology and the Argentine Federationof Cardiology. Its participation was free and anonymous. Objective Getting to know the number of catheter ablation procedures,treated arrhythmogenic substrates, results and complications,using the information provided by participants duringthe study period. Methods A retrospective registry of the procedures was carried out from January 1 to December 31st, 2010. A database was developed, and once completed by participants, was then unified into a single central database. Patients and centers were assigned number codes to ensure anonymity of data. Results The 24 centers reported 1,500 ablation procedures in 1,460patients. All patients were treated with radiofrequency. The most common substrates approached were tachycardia by AVnodal reentry (25%) and accessory bundles (25%), followed byatrial flutter (18%) and atrial fibrillation (16%). Overall successrate at the end of the procedures was 93.8%, and complications were present in 2.2% of the procedures. The most common complications were those related to vascular access (0.7%). Asingle death was recorded, due to pulmonary thromboembolism. Conclusions This third Argentine registry on catheter ablation providesimportant and useful information, and shows an adequate immediate success rate (93.4%), similar to those reported by previous national registries, with low incidence of morbidity and mortality rates. Therefore, in Argentina, this medical practice maintains similar efficacy and safety levels compared to other publications.

Five Years of Catheter Ablation Procedures in South‐Western Europe: Meta‐Analysis of National Registries

Radiofrequency catheter ablation is a well-established approach to treating several types of cardiac arrhythmias. The aim of our study was to provide data on the diffusion of catheter ablation procedures in clinical practice through a meta-analysis of National Registries of electrophysiological procedures performed over a 5-year period, from 2000 to 2005. We found only two national registries of catheter ablation procedures published in the journals indexed in PubMed: The Spanish Catheter Ablation Registry and the Portuguese National Registry on Cardiac Electrophysiology. In addition, we included in our analysis the data from the Italian Registry of Electrophysiological Procedures. This meta-analysis revealed a steady increase in the total number of catheter ablation procedures, particularly for the ablation of atrial flutter, of tachycardia due to double nodal pathways, and of the left atrial substrate in atrial fibrillation. However, the progress of catheter ablation and the impetus for additional research and development of new approaches and technologic advances requires further data on clinical indications, methodologic approach, complications, and long-term success rate in the real world.

Atrial Tachycardias Encountered in the Context of Catheter Ablation for Atrial Fibrillation Part II: Mapping and Ablation

Over the past decade, there has been an exponential increase in the number of catheter ablation procedures performed for atrial fibrillation (AF). While for paroxysmal AF, proximal pulmonary vein isolation is sufficient in the majority of cases, ablation of persistent and longstanding AF requires an extensive surgical-like procedure. This approach is correlated with a high rate of AF termination; however, this is achieved at the cost of at least one atrial tachycardia (AT) during the index procedure or during the patient's follow-up in the vast majority of cases. As these ATs are often multiple, complex, and frequently more symptomatic than AF, they constitute the last and frequently the most difficult step in ablation for patients with persistent AF. This review concentrates on the practical approaches to the treatment of AT in the context of AF ablation and provides an algorithm that aims at facilitating mapping and ablation strategies using conventional electrophysiological tools.

Atrial fibrillation ablation: a realistic alternative to pharmacologic therapy

There has been a rapid increase in the number of catheter ablation procedures for atrial fibrillation. Importantly, several new catheter-based strategies have shown atrial fibrillation to be a treatable condition. In this Viewpoint, Carlo Pappone and Vincenzo Santinelli discuss the best techniques for atrial fibrillation ablation.