![]() ![]() One patient died during the first year of follow-up and was excluded from the analyses. Statistical analyses were carried out with SPSS version 25.Īt 1 year, 62.9% ( n = 334/531) of the patients in the hospital district undergoing their first ablation had successfully maintained sinus rhythm. To compare the results over time, the median time of the procedures was selected as a cut-off point. A nominal p value of 0.05 was considered significant. All reported significance values are two-sided p values. Competing events (deaths) occurring within 1 year from the procedure were excluded from the Kaplan–Meier analysis. The Kaplan–Meier method was used to estimate event rates for redo procedures. Ablations for atrial fibrillation were not frequently performed during the first years of the study period ( n 200 annually). The study centre, Tays Heart Hospital, is a specialised tertiary care centre in Tampere (Finland). A dedicated electronic database for recording the details of invasive procedures (KARDIO) was used to identify patients who had undergone ablation for AF between 1 January 2010 and ( n = 1253 patients with n = 1514 procedures). This is a retrospective registry study on patients treated with catheter ablation for AF by means of pulmonary vein isolation (PVI) between 1 January 2010 and in Tays Heart Hospital. This data adds to the cost-efficiency analysis of catheter ablation and to the evaluation of the prognostic value of previously identified risk factors for AF recurrence, providing quality control data from a large centre (Tays Heart Hospital) responsible for tertiary services for a district with over one million residents in Finland. The purpose of this retrospective study was to examine the performance of a large centre performing catheter ablations for atrial fibrillation and to evaluate the prognostic value of several clinical variables as regards treatment success. In addition, there have been attempts to generate prediction models for AF recurrence after ablation, such as the APPLE score. These factors include the patient’s age, atrial fibrillation type (paroxysmal vs persistent), freedom from early recurrence at 3 months after the procedure, as well as left atrial size, left atrial fibrosis, obesity and other underlying conditions. In addition to centre size, other patient- or procedure-related factors have been identified as potential predictors of the maintenance of sinus rhythm after catheter ablation for AF. Quality control is also necessary for the purposes of evaluating cost-efficiency. In order to be considered as a first-line therapy in any given centre, the success rate for catheter ablation should be acceptable, with a correspondingly low complication risk. However, the success rate of AF ablation varies considerably in published reports, as do the complication rates, especially in a comparison between high- and low-volume centres. A relapse during a 3-month blanking period is associated with a very high risk of failure at 1 year.Ĭatheter ablation for atrial fibrillation (AF), similarly to antiarrhythmic drug (AAD) therapy, is generally an effective and relatively safe therapy aimed at restoring and maintaining sinus rhythm (SR) and, subsequently, also improving the quality of life. Patient-related factors are the most significant predictors of treatment success. Ten percent of the patients needed a redo procedure within the first year. The major complication rate was 4.5% (68/1514) with no deaths. A relapse during the first 3-month blanking period was associated with a nine-fold risk of failure at 1 year (unadjusted OR 9.1, 95% CI 5.5–15.1, p < 0.001). The experience at the centre did not associate with the 1-year outcome. ![]() Preoperative predictors of treatment success were paroxysmal AF type, previous use of antiarrhythmic drugs, left atrium diameter and age. Treatment success was observed in approximately 62.9% of the ablation-naïve patients. Treatment success (maintenance of sinus rhythm at 1 year) was evaluated among patients residing within the hospital district (45% of the entire study population). Comprehensive data on patient characteristics, treatment results, redo operations and complications were collected. Methodsĭata on patients ( n = 1,253) treated with catheter ablation for AF in Tays Heart Hospital between January 2010 and May 2018 was evaluated ( n = 1178 ablation-naïve patients and n = 1514 AF ablations). The aim of this study was to evaluate treatment success and its predictors and to provide quality control data on complications and redo operations in a centre with an initially a low but currently high annual volume. Catheter ablation for atrial fibrillation (AF) is a standard procedure for maintaining sinus rhythm. ![]()
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