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A decade of catheter ablation of cardiac arrhythmias in Sweden : ablation practices and outcomes

Holmqvist, Fredrik LU ; Kesek, Milos; Englund, Anders; Blomström-Lundqvist, Carina; Karlsson, Lars O.; Kennebäck, Göran; Poçi, Dritan; Samo-Ayou, Romeo; Sigurjónsdóttir, Runa and Ringborn, Michael LU , et al. (2019) In European Heart Journal 40(10). p.820-830
Abstract

AIMS: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. METHODS AND RESULTS: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory... (More)

AIMS: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. METHODS AND RESULTS: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%). CONCLUSION: Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.

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publication status
published
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keywords
Adverse events, Catheter ablation, Outcome
in
European Heart Journal
volume
40
issue
10
pages
11 pages
publisher
Oxford University Press
external identifiers
  • scopus:85062625318
ISSN
1522-9645
DOI
10.1093/eurheartj/ehy709
language
English
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yes
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c17c5d19-05bf-484c-a1a7-a8b1534e1133
date added to LUP
2019-03-19 12:08:24
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2019-05-21 04:19:47
@article{c17c5d19-05bf-484c-a1a7-a8b1534e1133,
  abstract     = {<p>AIMS: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. METHODS AND RESULTS: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P &lt; 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%). CONCLUSION: Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.</p>},
  author       = {Holmqvist, Fredrik and Kesek, Milos and Englund, Anders and Blomström-Lundqvist, Carina and Karlsson, Lars O. and Kennebäck, Göran and Poçi, Dritan and Samo-Ayou, Romeo and Sigurjónsdóttir, Runa and Ringborn, Michael and Herczku, Csaba and Carlson, Jonas and Fengsrud, Espen and Tabrizi, Fariborz and Höglund, Niklas and Lönnerholm, Stefan and Kongstad, Ole and Jönsson, Anders and Insulander, Per},
  issn         = {1522-9645},
  keyword      = {Adverse events,Catheter ablation,Outcome},
  language     = {eng},
  number       = {10},
  pages        = {820--830},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal},
  title        = {A decade of catheter ablation of cardiac arrhythmias in Sweden : ablation practices and outcomes},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehy709},
  volume       = {40},
  year         = {2019},
}