title: Contemporary management of patients undergoing atrial fibrillation ablation: in-hospital and 1-year follow-up findings from the ESC-EHRA atrial fibrillation ablation long-term registry.
abstract: OBJECTIVE
  The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome.
  
  
  RESULTS
  A total of 104 centres in 27 European countries participated and were asked to enrol 20-50 consecutive patients scheduled for first and re-do AFib ablation. Pre-procedural, procedural and 1-year follow-up data were captured on a web-based electronic case record form. Overall, 3630 patients were included, of which 3593 underwent an AFib ablation (98.9%). Median age was 59 years and 32.4% patients had lone atrial fibrillation. Pulmonary vein isolation was attempted in 98.8% of patients and achieved in 95-97%. AFib-related symptoms were present in 97%. In-hospital complications occurred in 7.8% and one patient died due to an atrioesophageal fistula. One-year follow-up was performed in 3180 (88.6%) at a median of 12.4 months (11.9-13.4) after ablation: 52.8% by clinical visit, 44.2% by telephone contact and 3.0% by contact with the general practitioner. At 12-months, the success rate with or without antiarrhythmic drugs (AADs) was 73.6%. A significant portion (46%) was still on AADs. Late complications included 14 additional deaths (4 cardiac, 4 vascular, 6 other causes) and 333 (10.7%) other complications.
  
  
  CONCLUSIONS
  AFib ablation in clinical practice is mostly performed in symptomatic, relatively young and otherwise healthy patients. Overall success rate is satisfactory, but complication rate remains considerable and a significant portion of patients remain on AADs. Monitoring after ablation shows wide variations. Antithrombotic treatment after ablation shows insufficient guideline-adherence.
authors.affiliation: Department of Cardiology, Cardiovascular Institute. Hospital Clínic de Barcelona. University of Barcelona, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Arbelo
authors.affiliation: Department of Cardiology, Cardiovascular Institute. Hospital Clínic de Barcelona. University of Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
authors.affiliation: EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Laroche
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
authors.affiliation: Arrhythmia Department and EP Laboratory, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pokushalov
authors.affiliation: Heart Center Co. Tampere University Hospital, Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Raatikainen
authors.affiliation: Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Efremidis
authors.affiliation: Department of Electrophysiology, University Leipzig - Heart Center, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Arrhythmia Unit, Cardiology Department, University Hospital Virgen de la Victoria, Malaga.
authors.forename: Alberto
authors.initials: A
authors.lastname: Barrera
authors.affiliation: EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.|Associazione Nazionale Medici Cardiologi Ospedalieri Research Center (AMCO Research Center), Florence, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Maggioni
authors.affiliation: GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.affiliation: Department of Electrophysiology, University Leipzig - Heart Center, Leipzig, Germany.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dagres
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies; D012042:Registries
chemical_list: D000925:Anticoagulants
keywords: Ablation; Atrial fibrillation; Complications; Management; Outcomes; Prospective registry