title: Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation.
abstract: BACKGROUND
  The purpose of this study was to provide an updated worldwide report on the methods, efficacy, and safety of catheter ablation of atrial fibrillation (AF).
  
  
  RESULTS
  A questionnaire with 46 questions was sent to 521 centers from 24 countries in 4 continents. Complete interviews were collected from 182 centers, of which 85 reported to have performed 20,825 catheter ablation procedures on 16,309 patients with AF between 2003 and 2006. The median number of procedures per center was 245 (range, 2 to 2715). All centers included paroxysmal AF, 85.9% also included persistent and 47.1% also included long-lasting AF. Carto-guided left atrial circumferential ablation (48.2% of patients) and Lasso-guided ostial electric disconnection (27.4%) were the most commonly used techniques. Efficacy data were analyzed with centers representing the unit of analysis. Of 16,309 patients with full disclosure of outcome data, 10 488 (median, 70.0%; interquartile range, 57.7% to 75.4%) became asymptomatic without antiarrhythmic drugs and another 2047 (10.0%; 0.5% to 17.1%) became asymptomatic in the presence of previously ineffective antiarrhythmic drugs over 18 (range, 3 to 24) months of follow-up. Success rates free of antiarrhythmic drugs and overall success rates were significantly larger in 9590 patients with paroxysmal AF (74.9% and 83.2%) than in 2800 patients with persistent AF (64.8% and 75.0%) and 1108 patients with long-lasting AF (63.1% and 72.3%) (P<0.0001). Major complications were reported in 741 patients (4.5%).
  
  
  CONCLUSIONS
  When analyzed in a large number of electrophysiology laboratories worldwide, catheter ablation of AF shows to be effective in approximately 80% of patients after 1.3 procedures per patient, with approximately 70% of them not requiring further antiarrhythmic drugs during intermediate follow-up.
authors.affiliation: Arrhythmias and Electrophysiology Center, IRCCS, Policlinico San Donato, Milan, Italy. riccardo.cappato@grupposandonato.it
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cappato
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
authors.forename: Wyn
authors.initials: W
authors.lastname: Davies
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Iesaka
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kalman
authors.forename: You-Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: George
authors.initials: G
authors.lastname: Klein
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.forename: Douglas
authors.initials: D
authors.lastname: Packer
authors.forename: Allan
authors.initials: A
authors.lastname: Skanes
authors.forename: Federico
authors.initials: F
authors.lastname: Ambrogi
authors.forename: Elia
authors.initials: E
authors.lastname: Biganzoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants