Patients with AF undergoing transcatheter ablation have a lower incidence of TE events as compared with the general AF population, regardless of OAT maintenance. The unpredictable risk of AF recurrence, mandate the routine use of the CHADS2, CHA2DS2VASc, and HAS-BLED scores to guide clinical decision regarding OAT management in this peculiar setting of patients. The potential protective role of rhythm control strategy in the TE events needs to be confirmed by future large randomized trials.

The outcome of AF ablation over more than 10 years is characterized by a low incidence of progression towards permanent AF. Greater LA anteroposterior diameter related to arrhythmic recurrences, while blood pressure, BMI, and fasting blood glucose control emerged as predictors of sinus rhythm maintenance. Eventually, QoL improved significantly over the follow-up.

Abstract:While radiation exposure related to natural sources plays a minor role, medicine-related exposure, represents, to date, a major exposure source. Within this exposure interventional electrophysiology is a relevant contributor. Unfortunately no safe dose in radioprotection exists, the negative acute and long term effects of radiological exposure may emerge at any radiation exposure dose. For this reason patients and physicians should be aware of the risk of radiation exposure and the benefits of the imaging/procedure balanced by the required radiation exposure. Given this, performing a near to zero x-rays transcatheter ablation procedure should therefore represent an aim for all electrophysiological lab. Fortunately, the introduction of electroanatomic mapping systems, have provided the possibility to perform simple and complex electrophysiological procedures avoiding, or at least, limiting the use of radiations. The present review summarizes state of the art of feasibility and safety of the near to zero approach for the main electrophysiological procedures, highlighting the potential health benefits.3

Considering this multicenter design study, AVK continuation following AFTCA, especially within patients with low-to-intermediate thromboembolic risk, confers a hemorrhagic risk greater to the thromboembolic protective effect. All thromboembolic events following AFTCA occur within patients experiencing atrial fibrillation relapses; therefore, in patients with high thromboembolic risk routine rhythm monitoring is essential after AVK discontinuation.