The DOI matches its Crossref record; 33 of the 34 references it cites were found in a registry or an index.
Updated Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation
Abstract
BACKGROUND: The purpose of this study was to provide an updated worldwide report on the methods, efficacy, and safety of catheter ablation of atrial fibrillation (AF). METHODS AND RESULTS: A questionnaire with 46 questions was sent to 521 centers from 24 countries in 4 continents. Complete interviews were collected from 182 centers, of which 85 reported to have performed 20,825 catheter ablation procedures on 16,309 patients with AF between 2003 and 2006. The median number of procedures per center was 245 (range, 2 to 2715). All centers included paroxysmal AF, 85.9% also included persistent and 47.1% also included long-lasting AF. Carto-guided left atrial circumferential ablation (48.2% of patients) and Lasso-guided ostial electric disconnection (27.4%) were the most commonly used techniques. Efficacy data were analyzed with centers representing the unit of analysis. Of 16,309 patients with full disclosure of outcome data, 10 488 (median, 70.0%; interquartile range, 57.7% to 75.4%) became asymptomatic without antiarrhythmic drugs and another 2047 (10.0%; 0.5% to 17.1%) became asymptomatic in the presence of previously ineffective antiarrhythmic drugs over 18 (range, 3 to 24) months of follow-up. Success rates free of antiarrhythmic drugs and overall success rates were significantly larger in 9590 patients with paroxysmal AF (74.9% and 83.2%) than in 2800 patients with persistent AF (64.8% and 75.0%) and 1108 patients with long-lasting AF (63.1% and 72.3%) (P<0.0001). Major complications were reported in 741 patients (4.5%). CONCLUSIONS: When analyzed in a large number of electrophysiology laboratories worldwide, catheter ablation of AF shows to be effective in approximately 80% of patients after 1.3 procedures per patient, with approximately 70% of them not requiring further antiarrhythmic drugs during intermediate follow-up.
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“In patients who experience symptomatic recurrences of AF despite antiarrhythmic drug therapy, all RCTs showed better sinus rhythm maintenance with catheter ablation than on antiarrhythmic drugs.586,713,727,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [727]
In the citing paper
“Five to seven per cent of patients will suffer severe complications after catheter ablation of AF, and 2-3% will experience life-threatening but usually manageable complications.727,[748][749][750]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [727]
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“However, AF ablation still remains a technically complex procedure bearing the potential risk for substantial complications despite novel technologies [3, 4].”
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Catheter ablation for atrial fibrillation
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“Catheter ablation of cardiac arrhythmias has become an effective treatment for different types of cardiac arrhythmias.(1,2) Antiarrhythmic drugs have limited efficacy and often need to be withdrawn due to secondary effects or pro-arrhythmia.”
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Global Survey of Esophageal Injury in Atrial Fibrillation Ablation
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Pulmonary vein antrum isolation leads to a significant decrease of left atrial size
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“known potential complications such as atrioesophageal fistula, steam pops, and coagulum formation, which can occur with high temperatures.(5) Furthermore, the lesions are typically placed outside of the pulmonary veins (PVs).”
BackgroundNonpharmacologic stroke prevention in atrial fibrillation
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“Several reports have been published concerning the safety of conventional catheter ablation procedures [1–6].”
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Nonfluoroscopic Catheter Visualization in Atrial Fibrillation Ablation
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“Additionally, in the most recent guidelines, AF ablation can now be considered as a primary treatment even before antiarrhythmic medications in young patients with lone AF.(4) As the indications for AF ablation continue to expand, there have been an abundance of new laboratories being established worldwide to meet the…”
BackgroundChinitz, L. A., Melby, D. P., Marchlinski, F. E., Delaughter, C., Fishel, R., Monir, G., Patel, A. M., Gibson, D. N., Athill, C. A., Boo, L. M., et al. (2017) · EP Europace · doi:10.1093/europace/eux264 · Cited by 51
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Efficacy and Safety of Apixaban in the Patients Undergoing the Ablation of Atrial Fibrillation
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“>Moderate puncture site hematoma 0 (0) 0 (0) N/A Minor bleeding 4 (4) 5 (5) 0.”
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“3% taking into account that this was registry-based data which can potentially under-report events.(18)”
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Catheter Ablation for Persistent Atrial Fibrillation
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“Corresponding Author Luca De Mattia Arrhythmia and EP Unit, Cardiology Department,Cà Foncello Hospital,Piazzale Ospedale n°1,31100 Treviso,Italy Key Words Radio Frequency Ablation, Contact Force, Lesion Index Introduction The The cornerstone of radiofrequency (RF) catheter ablation of paroxysmal atrial fibrillation (P…”
BackgroundDiagnosis‐to‐ablation time in atrial fibrillation: A modifiable factor relevant to clinical outcome
Bisbal, F., Alarcón, F., Ferrero‐de‐Loma‐Osorio, Á., González‐Ferrer, J. J., Alonso‐Martín, C., Pachón, M., Vallès, E., Cabanas‐Grandío, P., Sanchez, M., Benito, E., et al. (2019) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14000 · Cited by 50
“Centers were categorized as high (≥100 AF ablations/year) or low ( < 100 AF ablations/year) volume according to previous literature.(11)”
MethodPulmonary Vein Isolation Using a Pace-Capture–Guided Versus an Adenosine-Guided Approach
Andrade, J. G., Pollak, S. J., Monir, G., Khairy, P., Dubuc, M., Roy, D., Talajic, M. R., Deyell, M. W., Rivard, L., Thibault, B., et al. (2013) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.000454 · Cited by 49
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Leitlinien zur Katheterablation
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On Computing Dominant Frequency From Bipolar Intracardiac Electrograms
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Catheter ablation of permanent atrial fibrillation: medium term results
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Sohns, C., Sohns, J. M. S., Bergau, L., Sossalla, S. T., Vollmann, D., Lüthje, L., Staab, W., Dorenkamp, M., Harrison, J. L., O'Neill, M. D., et al. (2013) · EP Europace · doi:10.1093/europace/eut059 · Cited by 49
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“Non-lethal complications such as cardiac perforation, stroke and pulmonary vein stenosis have been reported to occur with rates of 1.3%, 0.2% and 1.3% respectively [ 1 ,2].”
BackgroundInfluentialZipes, D. P., Calkins, H. G., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Gupta, A., Indik, J. H., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.09.014 · Cited by 49
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“29%, in worldwide surveys).(9,22) Now, with the extensive use of the wide PVI strategy with the application of radiofrequency energy, the”
MethodLife-Threatening Complications of Atrial Fibrillation Ablation
Rehman, K. A., Wazni, O. M., Barakat, A. F., Saliba, W. I., Shah, S. Y., Tarakji, K. G., Rickard, J., Bassiouny, M., Baranowski, B. J., TCHOU, P. J., et al. (2019) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.11.013 · Cited by 49
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Haegeli, L., Duru, F., Lockwood, E. E., Lüscher, T. F., Sterns, L. D., NOVAK, P. G., & Leather, R. A. (2010) · Postgraduate Medical Journal · doi:10.1136/pgmj.2009.092510 · Cited by 48
Update on atrial fibrillation catheter ablation technologies and techniques
Dewire, J., & Calkins, H. G. (2013) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2013.121 · Cited by 48
Metzner, A., Chun, K. R. J., Neven, K. G. E. J., Fuernkranz, A., Ouyang, F. O., Antz, M., Tilz, R. R., Zerm, T., Koektuerk, B., Wißner, E., et al. (2010) · EP Europace · doi:10.1093/europace/eup416 · Cited by 48
II Diretrizes Brasileiras de Fibrilação Atrial
Magalhães, L., Figueiredo, M., Cintra, F., Eb, S., Kuniyoshi, R. R., Teixeira, R., Filho, A. L., d’Ávila, A., de Paola, A., Kalil, C., et al. (2016) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20160055 · Cited by 51
Asymptomatic Cerebral Infarction During Catheter Ablation for Atrial Fibrillation
Kimura, T., Kashimura, S., Nishiyama, T., Katsumata, Y., Inagawa, K., Ikegami, Y., Nishiyama, N., Fukumoto, K., Tanimoto, Y., Aizawa, Y., et al. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.08.003 · Cited by 48
Dhillon, G. S., Honarbakhsh, S., Monaco, A. D., Coling, A. E., Lenka, K., Pizzamiglio, F., Hunter, R. J., Horton, R., MANSOUR, M. C., Natale, A., et al. (2020) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14476 · Cited by 48
“These rates are in line with single procedure PVI with either point by point RF or cryoablation which is estimated to lie between 70%‐ 80%.(3,7,20,21) This study is underpowered for evaluation of long‐term outcomes of PVI with the RF balloon.”
ResultAryal, M. R., Ukaigwe, A., Pandit, A., Karmacharya, P., Pradhan, R., Mainali, N. R., Pathak, R., Jalota, L., Bhandari, Y., & Donato, A. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.05.038 · Cited by 47
Hwang, M., Kwon, S.-S., Wi, J. H., Park, M., Lee, H., Park, J. S., Lee, Y.-S., Shim, E. B., & Pak, H. (2014) · Progress in Biophysics and Molecular Biology · doi:10.1016/j.pbiomolbio.2014.09.006 · Cited by 47
“However, AF catheter ablation introduces the risk of collateral damages (Cappato et al., 2010), and longduration of ablation procedure is also known to be associated with poor clinical outcome (Shim et al., 2013).”
BackgroundMetzner, A., Wißner, E., Schmidt, B., Chun, K. R. J., Hindricks, G., Piorkowski, C., Ouyang, F. O., & Kück, K. (2012) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2012.02427.x · Cited by 47
Left Atrial Diverticula in Patients Referred for Radiofrequency Ablation of Atrial Fibrillation
Peng, L., Yu, J., Yang, Z., Wu, D., Xu, J.-J., Chu, Z., Li, X., Chen, D., Luo, Y., Shao, H., et al. (2012) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.111.965665 · Cited by 47
den Uijl, D. W., Delgado, V., Tops, L. F., Ng, A. C. T., Boersma, E. H., Trines, S. A. I. P., Zeppenfeld, K., Schalij, M. J., van der Laarse, A., & Bax, J. J. (2010) · American Heart Journal · doi:10.1016/j.ahj.2010.09.031 · Cited by 47
Bayrak, F., CHIERCHIA, G., Namdar, M., Yazaki, Y., Sarkozy, A., de Asmundis, C., Müller-Burri, S.-A., Rao, J. Y., Ricciardi, D., Sorgente, A., et al. (2011) · EP Europace · doi:10.1093/europace/eur366 · Cited by 47
“15%).(5) A recent large multicentre Italian survey (5520 TP procedures) reported severe complications (including one death), although the overall complication rate was low (0.”
BackgroundLip, G. Y. H., Al‐Khatib, S. M., Cosío, F. G., Banerjee, A., Savelieva, I., Ruskin, J. N., Blendea, D. C., Nattel, S., Bono, J. D., Conroy, J., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.114.001179 · Cited by 48
“In this survey, success rates were higher in patients with paroxysmal than persistent and long-standing AF, and 70% of patients did not require further AAD treatment during follow-up.(77) Reports from Canada of the costs, compared to medical therapy, for paroxysmal AF found catheter ablation a fiscally viable alternat…”
BackgroundNakamura, T., Okishige, K., Kanazawa, T., Yamashita, M., Kawaguchi, N., Kato, N., Aoyagi, H., Yamauchi, Y., Sasano, T., & Hirao, K. (2016) · EP Europace · doi:10.1093/europace/euw191 · Cited by 46
“However, pulmonary vein isolation (PVI) itself has a potential risk of cerebral infarctions.(3,4) Several previous studies undergoing post-procedural cerebral MRI have unmasked a considerable number of patients that developed SCI, 7 and it might be a cause of cognitive dysfunction.”
BackgroundLévy, S., Steinbeck, G., Santini, L., Näbauer, M., Penela, D., Kantharia, B. K., Saksena, S. V., & Cappato, R. (2022) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-022-01195-z · Cited by 50
Wieczorek, M., Hoeltgen, R., & Brueck, M. (2013) · Heart Rhythm · doi:10.1016/j.hrthm.2013.04.005 · Cited by 46
Sailing between Scylla and Charybdis: oral long-term anticoagulation in dialysis patients
Krüger, T., Brandenburg, V. M., Schlieper, G., Marx, N., & Floege, J. (2012) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfs485 · Cited by 46
“Catheter ablation is an effective therapy for patients with symptomatic atrial fibrillation and is associated with an overall low incidence of complications [42].”
BackgroundAsymptomatic brain lesions following laserballoon-based pulmonary vein isolation
Wißner, E., Metzner, A., Neužil, P., Petrů, J., Skoda, J., Sediva, L., Kivelitz, D. E., Wohlmuth, P., Weichet, J., SCHOONDERWOERD, B. A., et al. (2013) · EP Europace · doi:10.1093/europace/eut250 · Cited by 46
Understanding Atrial Fibrillation: The Signal Processing Contribution, Part II
Mainardi, L., Sörnmo, L., & Cerutti, S. (2008) · Synthesis lectures on biomedical engineering · doi:10.2200/s00153ed1v01y200809bme025 · Cited by 47
Chen, J., Dagres, N., Hocini, M., Fauchier, L., Bongiorni, M. G., Defaye, P., Hernández‐Madrid, A., Estner, H., Sciaraffia, E., & Blomström‐Lundqvist, C. (2015) · EP Europace · doi:10.1093/europace/euv315 · Cited by 46
“Similar complication rates were reported in this survey compared with the European, Asian, and worldwide AF surveys.(5,6,19) Remarkably, the complication rate remains stable over years.”
ResultGuhl, E., Siddoway, D., ADELSTEIN, E. C., Bazaz, R. R., Mendenhall, G. S., Němec, J., Saba, S., SCHWARTZMAN, D. S., Voigt, A., Wang, N. C., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003724 · Cited by 46
Yang, H.-M., Lai, C. K., Patel, J., Moore, J. W., Chen, P., Shivkumar, K., & Fishbein, M. C. (2007) · Cardiovascular Pathology · doi:10.1016/j.carpath.2006.07.007 · Cited by 46
Wu, L., Narasimhan, B., Ho, K. S., Zheng, Y., Shah, A. N., & Kantharia, B. K. (2021) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14979 · Cited by 45
DeSimone, C. V., Hu, T. Y., Ebrille, E., Syed, F. F., Vaidya, V. R., Cha, Y., Valverde, A. M., Friedman, P. A., Suri, R. M., & Asirvatham, S. J. (2014) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12439 · Cited by 45
Zipes, D. P., Calkins, H. G., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Gupta, A., Indik, J. H., et al. (2015) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/hae.0000000000000014 · Cited by 45
Factors Associated With Periesophageal Vagal Nerve Injury After Pulmonary Vein Antrum Isolation
Miyazaki, S., Taniguchi, H., Kusa, S., Komatsu, Y., Ichihara, N., Takagi, T., Iwasawa, J., Kuroi, A., Nakamura, H., Hachiya, H., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.114.001209 · Cited by 45
“04%, with no reports of PNI.(6) Consequently, most electrophysiologists have not paid attention to this complication, in contrast to direct esophageal injury.”
BackgroundInfluentialReed, J. L., Mark, A. E., Reid, R. D., & Pipe, A. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.09.020 · Cited by 45
Sriram, C. S., Banchs, J. E., Moukabary, T., Moradkhan, R., & Gonzalez, M. D. (2015) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-015-0008-2 · Cited by 45
“Despite a negative TEE result, catheter ablation of AF can result in manifest or silent embolic events [16].”
BackgroundChierchia, G., de Asmundis, C., Namdar, M., Westra, S. W., Kuniss, M., Sarkozy, A., Bayrak, F., Ricciardi, D., Casado-Arroyo, R., Rodríguez‐Mañero, M., et al. (2012) · EP Europace · doi:10.1093/europace/eus041 · Cited by 45
Douxfils, J., Tamigniau, A., Châtelain, B., Goffinet, C., Dogné, J.-M., & Mullier, F. (2014) · Thrombosis Journal · doi:10.1186/1477-9560-12-24 · Cited by 47
“The ideal management of oral anticoagulation during cardiopulmonary bypass [105,106] and catheter ablation for AF [107-109] is still controversial with a wide range of procedures available.”
BackgroundMagnetic Helical Robot for Targeted Drug-Delivery in Tubular Environments
Nam, J., Lee, W., Kim, J.-Y., & Jang, G. (2017) · IEEE/ASME Transactions on Mechatronics · doi:10.1109/tmech.2017.2761786 · Cited by 45
“W IRED catheters are popular in modern surgical procedures for the treatment of clogged tubular structures in the human body, such as blood vessels and the gastrointestinal tract [1]–[4].”
BackgroundCatheter Ablation for Atrial Fibrillation in Adults With Congenital Heart Disease
Sohns, C., Nürnberg, J., Hebe, J., Duckeck, W., Ventura, R., Konietschke, F., Cao, C., Siebels, J., & Volkmer, M. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.01.015 · Cited by 45
“Previous studies reported major complications in patients undergoing catheter ablation for AF in up to 5% in a population with an average age of 60 years (36,37) and Saguner et al.”
BackgroundRepeat procedure is a new independent predictor of complications of atrial fibrillation ablation
Szegedi, N., Széplaki, G., Herczeg, S., Tahin, T., Salló, Z., Nagy, V. K., Osztheimer, I., Özcan, E. E., Merkely, B. P., & Gellér, L. (2019) · EP Europace · doi:10.1093/europace/euy326 · Cited by 45
“46%.(2,4,5,7,9,15,16) There was no procedure related death in our patient population.”
BackgroundSugumar, H., Nanayakkara, S., Chieng, D., Wong, G. R., Parameswaran, R., Anderson, R. D., Al‐Kaisey, A., Nalliah, C. J., Azzopardi, S. M., Prabhu, S., et al. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.12.013 · Cited by 44
Zei, P. C., Quadros, K., Clopton, P., Thosani, A. J., Ferguson, J., Brodt, C. R., O’Riordan, G. E., Ramsis, M., Mitra, R., & Baykaner, T. (2020) · Journal of Innovations in Cardiac Rhythm Management · doi:10.19102/icrm.2020.111105 · Cited by 45
Minimally Invasive Epicardial Injections Using a Novel Semiautonomous Robotic Device
Ota, T., Patronik, N. A., SCHWARTZMAN, D. S., Riviere, C. N., & Zenati, M. A. (2008) · Circulation · doi:10.1161/circulationaha.107.756049 · Cited by 45
Schmidt, B., Chun, K. R. J., Ouyang, F. O., Metzner, A., Antz, M., & Kück, K. (2008) · Heart Rhythm · doi:10.1016/j.hrthm.2008.05.003 · Cited by 44
Atrial Fibrillation in Congestive Heart Failure
Seiler, J., & Stevenson, W. G. (2009) · Cardiology in Review · doi:10.1097/crd.0b013e3181c21cff · Cited by 44
Fatal course of esophageal stenting of an atrioesophageal fistula after atrial fibrillation ablation
Zellerhoff, S., Lenze, F., Schulz, R., & Eckardt, L. (2010) · Heart Rhythm · doi:10.1016/j.hrthm.2010.10.041 · Cited by 44
Nair, K. K. M., Shurrab, M., Skanes, A. C., Danon, A., Birnie, D. H., Morillo, C. A., Chauhan, V. S., Mangat, I., Paredes, F. A., Champagne, J., et al. (2013) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-013-9853-z · Cited by 44
Atrial‐Esophageal Fistula after Atrial Radiofrequency Catheter Ablation
Siegel, M., Parenti, D. M., & Simon, G. L. (2010) · Clinical Infectious Diseases · doi:10.1086/653425 · Cited by 44
Chierchia, G., Namdar, M., Sarkozy, A., Sorgente, A., de Asmundis, C., Casado-Arroyo, R., Capulzini, L., Bayrak, F., Rodríguez‐Mañero, M., Ricciardi, D., et al. (2012) · EP Europace · doi:10.1093/europace/eus189 · Cited by 44
Klinkenberg, T. J., Ahmed, S., ten Hagen, A., Wiesfeld, A. C. P., Tan, E. S., Zijlstra, F., & Gelder, I. C. V. (2009) · EP Europace · doi:10.1093/europace/eup299 · Cited by 44
Metadata
- Authors
- Cappato, R., Calkins, H., Chen, S.-A., Davies, W., Iesaka, Y., Kalman, J., Kim, Y.-H., Klein, G., Natale, A., Packer, D., Skanes, A., Ambrogi, F., & Biganzoli, E.
- Affiliations
- The Royal Melbourne Hospital (AU)
- ORCID
- Venue
- Circulation Arrhythmia and Electrophysiology
- Published
- 2010-02
- Volume
- 3
- Issue
- 1
- Pages
- 32-38
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- OpenAlex
- W2146673314
- Cited by
- 2,852
- References
- 34
- Citations by year
- 2026: 26 · 2025: 42 · 2024: 51 · 2023: 68 · 2022: 81 · 2021: 110 · 2020: 126 · 2019: 125 · 2018: 141 · 2017: 177 · 2016: 199 · 2015: 184 · 2014: 220 · 2013: 246 · 2012: 218
- FWCI
- 156.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Arrhythmia and Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- catheter ablation, atrial fibrillation, paroxysmal atrial fibrillation, persistent atrial fibrillation, ablation efficacy, ablation safety, procedural complications, CARTO system
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Data Collection, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Treatment Outcome, Catheter Ablation, Young Adult
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