title: High intensity focused ultrasound ablation for atrial fibrillation: results from the National Spanish Registry.
abstract: BACKGROUND
  A National Spanish Registry to compile all patients treated with high intensity focused ultrasound (HIFU) energy for atrial fibrillation (AF) was created to evaluate the safety and efficacy of AF surgical ablation.
  
  
  METHODS
  A national Spanish registry was created, and ten hospitals using HIFU to ablate AF joined it. A total of 412 patients undergoing cardiac surgery between 2006 and February 2013 were included. AF was divided between paroxysmal AF (33%) and persistent AF (67%) with a mean AF duration of 29.3±108.2 months. Mean left atrial diameter was 51.2±6.5 mm. Mean underlying heart disease were aortic valve disease (49.3%), ischemic disease (25.2%) and mitral disease (33.2%) Clinical follow-up of patients and a 6 months postoperative echocardiogram were performed in all patients.
  
  
  RESULTS
  A pacemaker implantation was needed in 4.9% of patients with a perioperative stroke in 2.5%. Rhythm at discharge from hospital was sinus rhythm in 58%, AF in 35.9% and atrial flutter in 0.8% of patients. Sinus rhythm restoration at 6, 12, 24 and 36 months follow-up was achieved in 66.1%, 63.8%, 63.9% and 45.9% of patients respectively. Multivariate analysis showed paroxysmal AF and sinus rhythm restoration in the operating theatre as factors related to sinus rhythm long term restoration.
  
  
  CONCLUSIONS
  The Spanish national registry showed an efficacy of AF ablation with the HIFU Epicor system of 66.1%, 63.8%, 63.9% and 45.9% at 6, 12, 24 and 36 months follow-up. There were no device-related complications.
authors.affiliation: Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain - guillermo_reyes_copa@yahoo.es.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Reyes
authors.forename: Xavier
authors.initials: X
authors.lastname: Ruyra
authors.forename: Francisco
authors.initials: F
authors.lastname: Valderrama
authors.forename: Antonio
authors.initials: A
authors.lastname: Jimenez
authors.forename: Dario
authors.initials: D
authors.lastname: Duran
authors.forename: Enrique
authors.initials: E
authors.lastname: Perez
authors.forename: Tomas
authors.initials: T
authors.lastname: Daroca
authors.forename: Javier
authors.initials: J
authors.lastname: Moya
authors.forename: Ulises
authors.initials: U
authors.lastname: Ramirez
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Aldamiz
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D004452:Echocardiography; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012042:Registries; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome