Survey of physician experience, trends and outcomes with atrial fibrillation ablation.
OBJECTIVE
We evaluated the prevalence, trends, outcomes and the general experience of physicians performing atrial fibrillation ablation (AF-ABL) in the United States (US).


BACKGROUND
AF-ABL is a non-pharmacological and potentially curative therapy for AF. Success rates for AF-ABL have been reported to be between 80 and 90%. Although there are numerous clinical trial addressing this therapy little is known about the general status of AF-ABL in clinical practice.


METHODS
We administered a mailed survey to the physician members of a professional arrhythmia society (Heart Rhythm Society, formerly known as the North American Society of Pacing and Electrophysiology) who practiced in the US (n = 1843).


RESULTS
There were 304 responses, 66% (n = 204) performed ABL and 30% (n = 92) performed AF-ABL. The study group performed a total of 5,592 AF-ABL from 2000 to 2003, out of 72,575 total ABL procedures during the same time period. There was a four-fold increase in the number of AF-ABL between 2000 and 2003 (2000: 628 vs. 2003: 2,575). In the same period, the self-reported short and long-term success rates of AF-ABL improved an average of 18 +/- 4% (p < or = 0.001). In 2003 the average self-reported one-month, one-year, and two-year success rates were: 71 +/- 4%, 66 +/- 5%, 63 +/- 6% respectively. The predicted five-year success was 60 +/- 4%. The average procedure took 4.5 +/- 0.4 hours. Physicians reported that approximately 29 +/- 4% of their patents were potential candidates for AF-ABL.


CONCLUSIONS
AF-ABL is becoming a much more common procedure in the US. Over the last four years the perceived short and long term success rates of AF-ABL have improved. Success rates in this survey are 10 to 20% lower than those reported in the recent clinical trials.
Mickelsen
Steven
S
University of New Mexico School of Medicine, Albuquerque, 87111, USA. mickelsens@nhlbi.nih.gov
Dudley
Ben
B
Treat
Eric
E
Barela
John
J
Omdahl
John
J
Kusumoto
Fred
F
D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation / Q000639:trends*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology