Rhythm monitoring, success definition, recurrence, and anticoagulation after atrial fibrillation ablation: results from an EHRA survey
Por:
Schwab, AC, Anic, A, Farkowski, MM, Guerra, J, Iliodromitis, KE, Jubele, K, Providencia, R, Chun, JKR, Boveda, S
Publicada:
1 ene 2023
Ahead of Print:
1 nov 2022
Resumen:
Atrial fibrillation (AF) is a major challenge for the healthcare field. Pulmonary vein isolation is the most effective treatment for the maintenance of sinus rhythm. However, clinical endpoints for the procedure vary significantly among studies. There is no consensus on the definition of recurrence and no clear roadmap on how to deal with recurrences after a failed ablation. The purpose of this study was to perform a survey in order to show how clinicians currently approach this knowledge gap. An online survey, supported by the European Heart Rhythm Association (EHRA) Scientific Initiatives Committee, was conducted between 1 April 2022 and 8 May 2022. An anonymous questionnaire was disseminated via social media and EHRA newsletters, for clinicians to complete. This consisted of 18 multiple-choice questions regarding rhythm monitoring, definitions of a successful ablation, clinical practices after a failed AF ablation, and the continuance of anticoagulation. A total of 107 replies were collected across Europe. Most respondents (82%) perform routine monitoring for AF recurrences after ablation, with 51% of them preferring a long-term monitoring strategy. Cost was reported to have an impact on the choice of monitoring strategy. Self-screening was recommended by most (71%) of the respondents. The combination of absence of symptoms and recorded AF was the definition of success for most (83%) of the respondents. Cessation of anticoagulation after ablation was an option mostly for patients with paroxysmal AF and a low CHA(2)DS(2)-VASc score. The majority of physicians perform routine monitoring after AF ablation. For most physicians, the combination of the absence of symptoms and electrocardiographic endpoints defines a successful result after AF ablation.
Filiaciones:
Schwab, AC:
Helios Frankenwaldklin Kronach, Dept Cardiol, Kronach, Germany
Anic, A:
Univ Hosp Ctr Split, Dept Cardiovasc Dis, Split, Croatia
Farkowski, MM:
Natl Inst Cardiol, Dept Heart Arrhythmia 2, Alpejska 42, PL-628 Warsaw, Poland
Guerra, J:
Univ Autonoma Barcelona, Dept Cardiol, Hosp Santa Creu & St Pau, IIB ST PAU,CIBERCV, Barcelona, Spain
Iliodromitis, KE:
Evangel Hosp Hagen Haspe, Clin Cardiol & Electrophysiol, Hagen, Germany
Jubele, K:
P Stradins Clin Univ Hosp, Arrhythmia Dept, Riga, Latvia
Riga Stradins Univ, Arrhythmia Dept, Riga, Latvia
Providencia, R:
Barts Hlth NHS Trust, Barts Heart Ctr, 5t Bartholomews Hosp, London, England
UCL, Inst Hlth Informat, London, England
Chun, JKR:
Markuskrankenhaus Frankfurt, CCB, Cardiol, Med Klin 3, Frankfurt, Germany
Boveda, S:
Clin Pasteur, Heart Rhythm Dept, F-31076 Toulouse, France
Univ Ziekenhuis Brussel VUB, Heart Rhythm Management Ctr, Brussels, Belgium
Paris Cardiovasc Res Ctr, INSERM, U970, F-75908 Paris 15, France
Green Published, hybrid, All Open Access, Hybrid Gold, Green
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