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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“Radiofrequency catheter ablation (RFCA) has emerged as an effective and curative treatment option for atrial fibrillation (AF) [1].”
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State of the art paper: Cardiac computed tomography of the left atrium in atrial fibrillation
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“Catheter ablation (CA) has generally been established as the standard therapy for atrial fibrillation (AF) (1, 2), and its popularity is gradually increasing (3).”
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“The main findings of this study is, that DC RFA of paroxysmal and persistent AF can reach a success rate around 80%, which is similar to conventional RFA in our patients and above international average [12].”
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Venous Thrombosis After Electrophysiology Procedures
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Anticoagulation of Cardiovascular Conditions in the Cancer Patient: Review of Old and New Therapies
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“Radiofrequency (RF) current is still the standard source of energy.(2) However, studies revealed comparable success and complication rates for using the cryoballoon (CB) instead of RF for ablation of pxAF but show controversial results with respect to procedure duration, as well as ablation and fluoroscopy time.”
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“74 y 11 (22) Hypertension 39 (80) Vascular disease* 5 (10) Diabetes 11 (23) Previous stroke/TIA 23 (47) On OAT 16 (70) HAS-BLED score 3 6 1 Impaired renal function 3 (6) Impaired liver function 1 (2) History of stroke 19 (39) History of bleeding 28 (57) Results Baseline patient population”
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“fibrillation (AF), with an increasing number of procedures worldwide [1].”
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Evaluation and Management of Arrhythmia in the Athletic Patient
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“Stroke is a severe complication of AF and PVI [1] but procedure-related, clinically manifest ischemic events are relatively rare.”
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“In larger series of patients undergoing LAAB, the mortality of AEF after PRFA is, depending on the study, 25–100% [3,8,13,31].”
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Applications of cardiac computed tomography in electrophysiology intervention
Liddy, S., Buckley, U., Kok, H. K., Loo, B., Glover, B. M., Dhillon, G. R., & Buckley, O. (2017) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jex312 · Cited by 28
“infarction and pulmonary hypertension.(7) CT can readily identify the location, length and degree of stenosis and can compare the appearances to those on pre-procedural images, although care should be taken to ensure the images are acquired at the same point of the cardiac cycle as the ostial diameter may vary by up t…”
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“[19] only had a 23% response rate.”
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“17–336] 48 [1–504] 0.”
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“Pulmonary vein (PV) isolation (PVI) has been widely performed as the mainstay of radiofrequency (RF) catheter ablation of atrial fibrillation (AF) [1, 2].”
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“Despite significant advances in catheter based ablation of AF/AFL, recurrences are still common [21].”
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“The incidence of periprocedural thromboembolic events varies from 1% to 7%, depending on the ablation and the anticoagulation strategy used in this period [4, 5].”
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“Three generations of prototype devices were tested in the right atrium and ventricle in 4 acute pig studies for the following characteristics: (1) image quality, ( 2 ) anatomic identification, (3) visualization of other catheter devices, and (4) for a mechanism for stabilization when imaging ablation.”
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“There were no in-hospital deaths and the incidence of perioperative strokes/TIAs (2%) is comparable to the results of transcatheter ablation [18, 19], despite no exclusion of the left atrial appendage being performed at the time of surgery.”
ResultManagement of cardiac conduction abnormalities and arrhythmia in aircrew
Guettler, N. J., Bron, D., Manen, O., Gray, G. W., Syburra, T., Rienks, R., D’Arcy, J. L., Davenport, E. D., & Nicol, E. D. (2018) · Heart · doi:10.1136/heartjnl-2018-313057 · Cited by 28
“52 53 Unlike PAF, the long-term success rate in patients with persistent AF is only 40–60% after a single ablation, 54 and in many cases a second or third intervention is necessary.”
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Echocardiographically guided left atrial ablation: Characterization of a new technique
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Severe Periprocedural Complications After Ablation for Atrial Fibrillation
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Randomized trial comparing robotic to manual ablation for atrial fibrillation
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“The risk of thromboembolic events is also present or even increased during and early after AF catheter ablation (11,12).”
BackgroundShurrab, M., Morillo, C. A., Schulman, S., Kansal, N., Danon, A., Newman, D. M., Lashevsky, I., Healey, J. S., & Crystal, E. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.07.005 · Cited by 26
Constrained Registration for Motion Compensation in Atrial Fibrillation Ablation Procedures
Brost, A., Wimmer, A., Liao, R. J., Bourier, F. J., Koch, M., Strobel, N. K., Kurzidim, K. W., & Joachim Hornegger, A. (2011) · IEEE Transactions on Medical Imaging · doi:10.1109/tmi.2011.2181184 · Cited by 27
“become an accepted treatment option, in particular, when drug therapy fails [3], [4], [5].”
BackgroundNairooz, R. S., Ayoub, K. F., Sardar, P., Payne, J. J., Almomani, A. A., Pothineni, N. V. K., Shailesh, F., Aronow, W. S., & Mukherjee, D. (2015) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2015.09.012 · Cited by 27
Pulmonary Vein Stenosis After Atrial Fibrillation Ablation: Insights From the ADVICE Trial
Samuel, M., Khairy, P., Mongeon, F., Andrade, J. G., Gomes, S., Galvan, Z., Weerasooriya, R., NOVAK, P. G., Nault, I., Arentz, T., et al. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.10.013 · Cited by 27
Maurer, T., Schlüter, M., & Kück, K. (2020) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2020.08.041 · Cited by 28
Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström‐Lundqvist, C., Boriani, G., Castellà, M., Dan, G., Dilaveris, P., et al. (2021) · Revista Española de Cardiología · doi:10.1016/j.recesp.2020.10.022 · Cited by 34
Hybrid ablation for atrial fibrillation: A systematic review and meta-analysis
Varzaly, J., Lau, D. H., Chapman, D., Edwards, J., Worthington, M. G., & Sanders, P. (2021) · JTCVS Open · doi:10.1016/j.xjon.2021.07.005 · Cited by 27
Sohns, C., Sossalla, S. T., Vollmann, D., Lüthje, L., Seegers, J., Schmitto, J. D., Zabel, M., & Obenauer, S. (2010) · International journal of cardiac imaging · doi:10.1007/s10554-010-9653-9 · Cited by 27
“Since Haissaguerre et al. [6] first described the elimination of arrhythmia triggers at the ostia of pulmonary veins by means of catheter based ablation, a very large number of ablation procedures have been performed worldwide [ 7 ].”
BackgroundAtrial fibrillation: Stroke prevention in focus
Ferguson, C., Inglis, S. C., Newton, P. J., Middleton, S., Macdonald, P. S., & Davidson, P. M. (2013) · Australian Critical Care · doi:10.1016/j.aucc.2013.08.002 · Cited by 27
Translational Research in Atrial Fibrillation
Atienza, F., Martins, R. P., & Jalife, J. (2012) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.111.970335 · Cited by 27
“Today, PV isolation by means of radiofrequency (RF) ablation is a gold standard treatment for paroxysmal AF.(4) However, the success rate of RF ablation in the more prevalent and highly heterogeneous persistent and long-term persistent AF populations has been disappointing.”
Moreira, W., Manusama, R., Timmermans, C. C., Ghaye, B., Philippens, S., Wellens, H. J. J., & Rodriguez, L. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.08.065 · Cited by 27
Navigator artifact reduction in three‐dimensional late gadolinium enhancement imaging of the atria
Keegan, J., Drivas, P., & Firmin, D. N. (2013) · Magnetic Resonance in Medicine · doi:10.1002/mrm.24967 · Cited by 27
“dures are often necessary due to incomplete isolation (4).”
BackgroundRienzo, F. D., Gabdoulline, R. R., Wade, R. C., Sola, M., & Menziani, M. C. (2004) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-004-3181-5 · Cited by 27
Imaging and Diagnostic Testing
Ekery, D., Davidoff, R., Orlandi, Q. G., Apstein, C. S., Hesselvik, J. F., Shemin, R. J., & Shapira, O. M. (2003) · American Heart Journal · doi:10.1016/s0002-8703(02)94786-1 · Cited by 28
JCS / JHRS 2024 Guideline Focused Update on Management of Cardiac Arrhythmias
Iwasaki, Y., Noda, T., Akao, M., Fujino, T., Hirano, T., Inoue, K., Kusano, K., Nagai, T., Satomi, K., Shinohara, T., et al. (2025) · Journal of Arrhythmia · doi:10.1002/joa3.70033 · Cited by 28
Sairaku, A., Nakano, Y., Oda, N., Uchimura, Y., Tokuyama, T., Kawazoe, H., Fujiwara, M., Watanabe, Y., Matsumura, H., & Kihara, Y. (2014) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12445 · Cited by 26
Management of Non-Vitamin K Antagonist Oral Anticoagulants in the Perioperative Setting
Dincq, A.-S., Lessire, S., Douxfils, J., Dogné, J., Gourdin, M. J., & Mullier, F. (2014) · BioMed Research International · doi:10.1155/2014/385014 · Cited by 26
“Finally, target ACT should be redetermined for the periprocedural use of NOACs for AF ablation [111–117].”
BackgroundVámos, M., Cappato, R., Marchlinski, F. E., Natale, A., & Hohnloser, S. H. (2016) · EP Europace · doi:10.1093/europace/euv408 · Cited by 25
“0%.(3) Atrial fibrillation ablation also carries a risk for silent cerebrovascular events, the consequences of which remain unclear.”
BackgroundInfluentialTakarada, K., Overeinder, I., de Asmundis, C., Ströker, E., Mugnai, G., Regibus, V. D., Moran, D., Coutiño-Moreno, H. E., Abugattás-Torres, J. P., Choudhury, R., et al. (2017) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-017-0237-7 · Cited by 26
Reißmann, B., Budelmann, T., Wißner, E., Schlüter, M., Heeger, C.-H. H., Mathew, S., Maurer, T., Lemeš, C., Fink, T., Rillig, A., et al. (2017) · Clinical Research in Cardiology · doi:10.1007/s00392-017-1199-6 · Cited by 26
“Major procedural complications occurred in a total of four patients; this incidence is comparable to the previous reports regarding safety of AF ablation [21].”
ResultTroisi, F., Guida, P., Quadrini, F., Monaco, A. D., Vitulano, N., Caruso, R., Orfino, R., Cecere, G., Anselmino, M., & Grimaldi, M. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.804424 · Cited by 26
“4%), compared to the complication rate described in literature (29, 30), without differences between ablation with and without fluoroscopy; this means that the latter approach does not increase procedural risks.”
ResultJiménez‐Candil, J., Hernández‐Rivas, J. M., Galbán, A. C., Blanco-Fernández, F., Morinigo, J., García, M., Manzanas, A. O., & Sanchez, P. L. (2023) · EP Europace · doi:10.1093/europace/euad265 · Cited by 26
“In addition, most of the acute complications that appear in AF ablation procedures are related to vascular access and haemostasis.(17) In our experience, the n = 667 patients undergoing PVI Same-day discharge as default strategy”
Scharf, C., Ng, G. A., Wieczorek, M., Deneke, T., FURNISS, S. S., Murray, S., Debruyne, P., Hobson, N., Berntsen, R. F., Schneider, M., et al. (2012) · EP Europace · doi:10.1093/europace/eus188 · Cited by 26
“However, despite the same limitations, the survey on conventional RFA of AF has been conducted twice because of the importance of the results.(8,9) Selected study populations do not reflect overall outcome of a procedure and it is, therefore, important to collect results from Figure 1 Overall success rates and total c…”
BackgroundTask-space motion planning of MRI-actuated catheters for catheter ablation of atrial fibrillation
Greigarn, T., & Çavuşoğlu, M. C. (2014) · IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS) · doi:10.1109/iros.2014.6943047 · Cited by 26
“It was pointed in [2] that the success rate of manual ablations appear to increase with skill and experience of the physician.”
BackgroundAhmad, A., Schlindwein, F. S., & Ng, G. A. (2010) · Journal of Biomedical Science and Engineering · doi:10.4236/jbise.2010.39114 · Cited by 26
“0% complication was recorded (524/8745) [11].”
Hemoptysis After Pulmonary Vein Isolation with a Cryoballoon: An Analysis of the Potential Etiology
Bhagwandien, R. E., Belle, Y. V., de Groot, N. M. S., & Jordaens, L. J. L. M. (2011) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02031.x · Cited by 26
Hayashi, M., Kaneko, S., Shimano, M., Ohashi, T., Kubota, R., Takeshita, K., Shinoda, M., Inden, Y., Kanayama, H., & Murohara, T. (2013) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gft233 · Cited by 26
Disertori, M., Lombardi, F., Barlera, S., Latini, R., Maggioni, A. P., Zeni, P., Pasquale, G. D., Cosmi, F., & Franzosi, M. G. (2010) · American Heart Journal · doi:10.1016/j.ahj.2010.02.016 · Cited by 26
Ottaviano, L., Chierchia, G., Bregasi, A., Bruno, N., Antonelli, A., Alsheraei, A., Porrini, A. M., Gronda, E., Donatelli, F., Duijnhower, A.-L., et al. (2013) · EP Europace · doi:10.1093/europace/eus431 · Cited by 26
Jin, Q., Pehrson, S. M., Jacobsen, P. K., & Chen, X. (2016) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12929 · Cited by 26
Atrio-Esophageal Fistula: A Case Series and Literature Review
Schuring, C. A., Mountjoy, L. J., Priaulx, A. B., Schneider, R. J., Smith, H. L., Wall, G. C., Kadaria, D., & Sodhi, A. (2017) · American Journal of Case Reports · doi:10.12659/ajcr.903966 · Cited by 28
“Early reports speculated the incidence of atrio-esophageal fistula to be higher due to missed diagnosis [4,5,9,12].”
BackgroundBuiatti, A., von Olshausen, G., Martens, E., Schinke, K., Laugwitz, K., Hoppmann, P., & Ibrahim, T. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.11.100 · Cited by 26
Zucchelli, G., Sirico, G., Rebellato, L., Marini, M., Stabile, G., Greco, M. D., Castro, A., Ruvo, E. D., Soldati, E., Zingarini, G., et al. (2018) · Circulation Journal · doi:10.1253/circj.cj-17-0421 · Cited by 26
Impact of Atrial Fibrillation Ablation on Recurrent Hospitalization
Guo, J., Nayak, H. M., Besser, S. A., Beaser, A. D., Aziz, Z. A., Broman, M., Özcan, C., Tung, R. H., & Upadhyay, G. A. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.10.015 · Cited by 26
“A worldwide multicenter survey found approximately 70% of patients could achieve this goal (17).”
BackgroundCan we improve outcomes in AF patients by early therapy?
Kirchhof, P. F. (2009) · BMC Medicine · doi:10.1186/1741-7015-7-72 · Cited by 26
“At present, the safety profile of catheter ablation of AF in relation to its efficacy has not been clearly delineated: Success rates are high, especially in paroxysmal AF patients, but complication rates are not negligible [43-45], and although most complications can be managed without long-term sequelae, there is a r…”
BackgroundAblation of Atrial Fibrillation
Riley, M. J., & Marrouche, N. F. (2006) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2006.01.002 · Cited by 26
Paraggio, L., Bianchini, F., Aurigemma, C., Romagnoli, E., Bianchini, E., Zito, A., Lunardi, M., Trani, C., & Burzotta, F. (2024) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.124.014156 · Cited by 25
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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