Catheter ablation for atrial fibrillation: results from the first European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA) Part II

Europace. 2015 Nov;17(11):1727-32. doi: 10.1093/europace/euv315. Epub 2015 Oct 12.

Abstract

The European Snapshot Survey on Procedural Routines in Atrial Fibrillation Ablation (ESS-PRAFA) is a prospective, multicentre snapshot survey collecting patient-based data on current clinical practices during atrial fibrillation (AF) ablation. The participating centres were asked to prospectively enrol consecutive patients during a 6-week period (from September to October 2014). A web-based case report form was employed to collect information of patients and data of procedures. A total of 455 eligible consecutive patients from 13 countries were enrolled (mean age 59 ± 10.8 years, 28.8% women). Distinct strategies and endpoints were collected for AF ablation procedures. Pulmonary vein isolation (PVI) was performed in 96.7% and served as the endpoint in 91.3% of procedures. A total of 52 (11.5%) patients underwent ablation as first-line therapy. The cryoballoon technique was employed in 31.4% of procedures. Procedure, ablation, and fluoroscopy times differed among various types of AF ablation. Divergences in patient selection and complications were observed among low-, medium-, and high-volume centres. Adverse events were observed in 4.6% of AF ablation procedures. In conclusion, PVI was still the main strategy for AF ablation. Procedure-related complications seemed not to have declined. The centre volume played an important role in patient selection, strategy choice, and had impact on the rate of periprocedural complication.

Keywords: Atrial fibrillation; Catheter ablation; Complication; Cryoballoon; Endpoint; Irrigated radiofrequency catheter; Strategy; Survey.

Publication types

  • Multicenter Study
  • Review

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods*
  • Cryosurgery* / adverse effects
  • Europe
  • Female
  • Fluoroscopy
  • Health Care Surveys
  • Hospitals, High-Volume
  • Hospitals, Low-Volume
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Practice Patterns, Physicians'
  • Prospective Studies
  • Pulmonary Veins / physiopathology
  • Pulmonary Veins / surgery*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome