title: Current status of catheter ablation of atrial fibrillation in Japan: Summary of the 4th survey of the Japanese Catheter Ablation Registry of Atrial Fibrillation (J-CARAF).
abstract: The Japanese Heart Rhythm Society performs an annual survey, J-CARAF, to collect data on the atrial fibrillation (AF) ablation procedure, and requests its members to register data for AF ablation performed in specified months. We compared data from the latest survey (September 2013, n=1049) with that of the previous survey (September 2012, n=1246) to investigate trends related to the AF ablation procedure.
  
  
  
  Patients in the latest survey were older (September 2012 vs. September 2013, 62.1±10.7 years vs. 63.3±10.8 years, p=0.012), and fewer used antiarrhythmic drugs (73.3% vs. 67.4%, p<0.0001). The fluoroscopic time decreased significantly (65.2±47.2min vs. 57.4±38.8min, p<0.0001), although the frequency of left atrial linear ablation increased (21.5% vs. 28.2%, p=0.0002). The use of factor Xa inhibitors (FXaI) during and post-procedure considerably increased (during, 3.0% vs. 15.8%; post, 3.7% vs. 32.8%, p<0.0001), whereas warfarin and direct thrombin inhibitor (DTI) were used less as oral anticoagulants during or after the procedure (warfarin: during, 47.8% vs. 33.7%; after, 55.2% vs. 37.5%; DTI: during, 21.2% vs. 16.0%; after 38.4% vs. 28.3%; p<0.0001).
  
  
  
  On comparison of the data from the surveys, the AF ablation procedure was observed to be performed in older patients and as a first-line therapy in Japan. In addition, more intensive ablation with less fluoroscopy was an observed trend. The use of FXaI during and after the procedure increased considerably, while the use of warfarin and DTI decreased.
authors.affiliation: Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan. Electronic address: koichi@inoue.name.
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Fourth Department of Internal Medicine, Teikyo University, Kawasaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Murakawa
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nogami
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Shoda
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.affiliation: Heart Rhythm Center, Fukuoka Sanno Hospital, Fukuoka, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Division of Cardiology, Nihon Medical School, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyauchi
authors.affiliation: The Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.affiliation: Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Japan.
authors.forename: Norishige
authors.initials: N
authors.lastname: Morita
authors.affiliation: Division of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods / Q000639:trends*; D065427:Factor Xa Inhibitors / Q000627:therapeutic use; D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011184:Postoperative Period; D012042:Registries; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors; D014859:Warfarin
keywords: Atrial fibrillation; Catheter ablation; Complication; Oral anticoagulant; Pulmonary vein isolation