Abstract
Catheter ablation (CA) has become standard therapy for atrial fibrillation, especially for paroxysmal atrial fibrillation. Precise single center follow-up (FU) data (especially long-term FU data) are published infrequently.
Methods: We studied 303 consecutive patients (172 males, 131 females, mean age 57 years) who underwent catheter ablation for atrial fibrillation (489 procedures) in years 2004-2012. Clinical examination, ECG, 24-h or 7-day Holter monitoring and quality of life (QoL) measurement (EQ-5D) was performed at 3, 6, 12, 18 and 24-month FU.
Results: FU data longer than 6 month after the first procedure are available for 135 patients with paroxysmal, 84 patients with persistent and 48 patients with longstanding persistent AF. The success rate after 6 month after the first procedure (sinus rhythm without AA drugs, no arrhythmias) was 48% for paroxysmal, 43% for persistent and 44% for longstanding persistent AF.
The complication rate was 3.3% (16 patients, no deaths, no pulmonary vein stenosis, 5 incidents of pericardial effusion treated with pericardiocentesis; 1 transitory ischemic attack; the remainder were local complications in the groin). The success rate after the last procedure (mean FU 24+-16 month, 1.6 procedure per patient) was 80% for paroxysmal and 58% for persistent and longstanding persistent AF.
QoL increased significantly in all groups of patients. Conclusion: With the standard procedure we can achieve acceptable results (success rate 60-80% with repeated procedures) with low complication rate even in a "lower volume" center.
In selected patients (with paroxysmal AF preferring interventional treatment) can be CA recommended as first-line therapy for rhythm control. CA improves QoL in our patients with AF.
As there is no gold standard to measure QoL in AF patients, EQ-5D seems to be a simple, quick and useful tool. (C) 2012 The Czech Society of Cardiology.