Log in to MyACC
Catheter Ablation of Cardiac Arrhythmias in Sweden
Study Questions:
What are the real-world data on efficacy and safety of catheter ablation for tachyarrhythmias?
Methods:
The investigators included 26,642 consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between January 1, 2006 and December 31, 2015 in the study. Follow-up (repeat ablation and vital status) was collected through December 31, 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, 4,034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7,358 atrioventricular (AV)-nodal re-entrant tachycardia (21%), 1,813 atrial tachycardia (5.2%), 5,481 typical atrial flutter (16%), 11,916 atrial fibrillation (AF; 35%), 2,415 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). For comparison between different years of ablation, independent sample Kruskal–Wallis test (continuous variables) or Mantel–Haenszel test for trend (categorical variables) was used.
Results:
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%).
Conclusions:
The authors concluded that catheter ablations have shifted towards more complex procedures over the past decade.
Perspective:
This population-based registry reports a doubling of the number of ablations over a 10-year period. Ablation of AF was the main driver behind this increase and accounts for 40% of all ablations performed in Sweden in 2015. Furthermore, the use of fluoroscopy time is steadily declining, with the largest decline seen for the more complex procedures. Overall, data suggest that catheter ablation is a safe procedure, with low reported adverse event rates, including mortality rates when performed in the appropriate setting.
Keywords: Accessory Atrioventricular Bundle, Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Flutter, Catheter Ablation, Fluoroscopy, Secondary Prevention, Tachycardia, Ventricular, Ventricular Premature Complexes, Wolff-Parkinson-White Syndrome
< Back to Listings
