Feature | September 11, 2012

Gold Standard of Success Defined for AF Ablation

Update on consensus statement on management of atrial fibrillation

September 11, 2012 — Since the previous consensus document was published in 2007, catheter and surgical ablation of atrial fibrilliation (AF) have become standard treatments and more randomized trials of ablation versus optimal drug therapy for AF have been conducted. “Significantly more data exist on techniques, success rates and complications of these new interventions, making this a more valid document compared to 2007,” said Professor Karl Heinz Kuck of Germany, president-elect of the European Heart Rhythm Association (EHRA) and co-chair of the task force that developed the latest document.

“Data from randomized trials clearly indicate that catheter ablation is superior to any drug treatment for recurrences of AF and quality of life. But the long term outcome is not as good as we thought in 2007,” added Kuck.

Newly analyzed data on the long-term outcome after successful ablation of long-standing persistent AF shows that just 40 to 50 percent of patients remain free of recurrent AF after five years. The increased volume of data enabled the authors to calculate minimum acceptable success rates for the different types of AF for the first time. Success was defined as freedom from AF, atrial flutter (AFL) and atrial tachycardia (AT) and no antiarrhythmic drug therapy. At 12 months following the ablation procedure, the minimum acceptable success rates are 50 percent for paroxysmal AF, 40 percent for persistent AF and 30 percent for longstanding persistent AF.

Also for the first time, the authors state that the maximum overall complication rate should be in the region of 4.5 percent. “For an invasive procedure, you want to know how successful it is but you also want to know how risky is it,” said Kuck. “In this paper we clearly define the maximum overall complication rate so that patients can see if an institute is performing adequately.”

Standards are clearly set out for the design of clinical trials. The minimum set of data that should be published is outlined, along with the endpoints and definitions that should be used. “This should increase standardization of trials and enable researchers, patients and organizations to compare success and complication rates more easily,” said Kuck.

Another new feature in the 2012 document is a recommendation to perform catheter ablation in patients with paroxysmal AF and no or minimal underlying heart disease as a first-line treatment. Previous recommendations said these patients should first receive an anti-arrhythmic drug and only proceed to catheter ablation if the drug failed.

“This comprehensive state-of-the-art review of the field of catheter and surgical ablation of AF sets out standards for success rates, complication rates and clinical trial design. This will help patients, doctors, researchers and organizations to see which doctors and institutions are up to scratch and where improvements are needed,” concluded Kuck.

“Forty-five experts from around the world representing seven different organizations have come together to develop a consensus for successful catheter and surgical ablation of atrial fibrillation. It is our hope that this guidance will help to ensure that patients seeking treatment will receive high quality care regardless of where they live and also bring us one step closer to ending pain and suffering due to heart rhythm disorders,” said Anne M. Gillis, M.D., FHRS, president of Heart Rhythm Society.

For more information: www.hrsonline.org

Related Content

coherex Wave Crest LAA Occluder

Coherex WaveCrest Left Atrial Appendage (LAA) Occlusion System.

News | November 24, 2015
November 24, 2015 — Biosense Webster announced it has acquired Coherex Medical Inc., a privately held medical device
News | Heart Valve Repair| November 23, 2015
NaviGate Cardiac Structures Inc. (NCSI) announced that a first-in-human implant of its catheter-guided, mitral-valved...
Boston Scientific, Watchman FLX, LAA closure device, CE mark, first European implants

Image courtesy of Boston Scientific

News | Left Atrial Appendage (LAA) Occluders| November 20, 2015
Boston Scientific announced the first implants of the Watchman FLX left atrial appendage closure (LAAC) device
iRhythm Technologies, ZIO continuous cardiac monitoring service, myZIO app, irregular heartbeat symptoms, reporting

Image courtesy of iRhythm Technologies

Technology | ECG Monitoring Services| November 19, 2015
iRhythm Technologies Inc. announced the launch of new patient engagement tools to enhance the diagnosis of cardiac...
wearable Holter monitors, iRhythm, ziopatch, zio patch

iRhythm Technologies Zio Patch was among the first of a new generation of simplified, wearable Holter monitors designed to increase ease of use and patient compliance to increase detection of arrhythmias that may lead to stroke.

Feature | Holter Monitoring Systems| November 16, 2015 | Judy Lenane, RN, MHA
One-third of ischemic strokes are classified as cryptogenic.
protein reprogramming, Stem Cells Translational Medicine, cardiac progenitor cells, CPCs, regenerative therapies
News | Stem Cell Therapies| November 13, 2015
A new study appearing in STEM CELLS Translational Medicine (SCTM) describes a highly efficient, protein-based method...
angina, abnormal heart blood flow, female-pattern heart disease, Cedars-Sinai Heart Institute study, AHA Scientific Sessions
News | Cardiac Diagnostics| November 13, 2015
Chest pain in female-pattern heart disease is linked with abnormal heart blood flow, a new Cedars-Sinai Heart Institute...
News | Antiplatelet and Anticoagulation Therapies| November 12, 2015
Preventing blood clots with drugs such as heparin has become a common practice for fighting some heart and lung...
pharmacist-physician collaboration, high blood pressure control, minority and low-income populations
News | Hypertension| November 12, 2015
November 12, 2015 — A pharmacist-physician collaborative effort to control blood pressure among a diverse group of pa
obese kids, eight years old, heart disease, MRI, Linyuan Jing
News | Cardiac Diagnostics| November 11, 2015
Imaging tests of obese children — some as young as 8 years old — showed signs of significant heart disease and heart...
Overlay Init