Cor Vasa 2012, 54(11-12):e369-e374 | DOI: 10.1016/j.crvasa.2012.11.007

Catheter ablation for atrial fibrillation - Single center experience

Luděk Haman^*, Hana Dostálová, Petr Pařízek

I. interní kardioangiologická klinika, Lékařská fakulta Univerzity Karlovy v Hradci Králové a Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

Aims: Catheter 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.

Methods: We 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.

Results: FU data longer than 6 months after the first procedure are available for 135 patients with paro-xysmal, 84 patients with persistent and 48 patients with long-standing persistent AF. The success rate after 6 months after the first procedure (sinus rhythm without AA drugs, no arrhythmias) was 48% for paroxysmal, 43% for persistent and 44% for long-standing 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 months, 1.6 procedure per patient) was 80% for paroxysmal and 58% for persistent and long-standing persistent AF. QoL increased significantly in all groups of patients.

Conclusion: With 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) CA can be 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 pa-tients, EQ-5D seems to be a simple, quick and useful tool.

Keywords: Atrial fibrillation; Catheter ablation; Quality of life

Received: October 17, 2012; Revised: November 10, 2012; Accepted: November 12, 2012; Published: November 1, 2012  Show citation