Regional differences in referral, procedures, and outcome after ablation for atrial fibrillation in Europe: a report from the Atrial Fibrillation Ablation Pilot Registry of the European Society of Cardiology

Sam Riahi*, Elena Arbelo, Josep Brugada, Aldo Pietro Maggioni, Luigi Tavazzi, Panos Vardas, Cecile Laroche, Michalis Efremidis, Olivier Xhaet, Aleksandra Wozniak, Isabelle C. Van Gelder, Soren Hjortshoj

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Scopus)

Abstract

Ablation is an effective treatment of symptomatic and drug refractory atrial fibrillation (AF). Using data from the European AF Ablation Pilot Registry comprising 1410 patients from 10 European countries, we prospectively investigated regional differences in AF ablation regarding patient selection, ablation strategy, and outcome.

Countries were divided into three regions: South (Greece, Italy, Spain), East (Czech Republic, Poland), and West/North (Belgium, Denmark, France, Germany, and the Netherlands). One-year success was defined as patient survival free from atrial arrhythmia, with or without antiarrhythmic drugs (AAD). In all regions, patients were symptomatic and treated extensively with beta-blockers and AAD pre-ablation. Patients in East had more co-morbidity, increased thromboembolic risk, were more likely to have paroxysmal AF, and they underwent more left atrial linear ablations. Adverse events remained within expected levels, albeit with a significantly higher reporting of adverse cardiovascular events in the West/North (4.7 vs. 1.4 and 1.5% in South and East, P = 0.0032). There was no significant difference in peripheral/vascular, neurological, pulmonary, gastrointestinal, or general adverse events. The 1-year success rate after ablation differed non-statistically between regions ranging from 69.1 to 74.7%. A second ablation was performed in 23.2% in West/North compared with 10.5 and 16.5% in South and East. The proportion of patients still on AADs was highest in the South region (51.6 vs. 42.3 and 38.8% in East and West/North).

This study with all-comer patients shows that patient selection for ablation follows current guidelines but reveals significant differences regarding co-morbidity, medication, and ablation strategy. Despite this, 1-year outcomes are without significant differences and in line with previously published clinical trials.

Original languageEnglish
Pages (from-to)191-200
Number of pages10
JournalEuropace
Volume18
Issue number2
DOIs
Publication statusPublished - 1-Feb-2016

Keywords

  • Atrial fibrillation
  • Ablation
  • Complications
  • Outcome
  • Registry
  • HEART RHYTHM ASSOCIATION
  • EUROBSERVATIONAL RESEARCH-PROGRAM
  • CATHETER ABLATION
  • ANTIARRHYTHMIC-DRUGS
  • RANDOMIZED-TRIAL
  • FOLLOW-UP
  • RADIOFREQUENCY ABLATION
  • 1ST-LINE TREATMENT
  • MANAGEMENT
  • STROKE

Cite this