2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

Calkins, Hugh; Hindricks, Gerhard; Cappato, Riccardo; Kim, Young Hoon; Saad, Eduardo; Aguinaga, Luis; Akar, Joseph G.; Badhwar, Vinay; Brugada, Josép; Camm, John; Chen, Peng‐Sheng; Chen, Shih‐Ann; Chung, Mina K.; Nielsen, Jens Cosedis; Curtis, Anne B.; Davies, D. Wyn; Day, John D.; d’Ávila, André; Groot, Natasja M.S. de; Biase, Luigi Di; Duytschaever, Mattias; Edgerton, James R.; Ellenbogen, Kenneth A.; Ellinor, Patrick T.; Ernst, Sabine; Fenelon, Guilherme; Gerstenfeld, Edward P.; Haines, David E.; Haı̈ssaguerre, Michel; Helm, Robert H.; Hylek, Elaine M.; Jackman, Warren M.; Jalife, José; Kalman, Jonathan M.; Kautzner, Josef; Kottkamp, Hans; Kuck, Karl Heinz; Kumagai, Koji; Lee, Richard; Lewalter, Thorsten; Lindsay, Bruce D.; Macle, Laurent; Mansour, Moussa; Marchlinski, Francis E.; Michaud, Gregory F.; Nakagawa, Hiroshi; Natale, Andrea; Nattel, Stanley; Okumura, Ken; Packer, Douglas L.; Pokushalov, Evgeny; Reynolds, Matthew R.; Sanders, Prashanthan; Scanavacca, Maurício; Schilling, Richard J.; Tondo, Claudio; Tsao, Hsuan-Ming; Verma, Atul; Wilber, David J.; Yamane, Teiichi

doi:10.1093/europace/eux275

Cited by 445 publications

(346 citation statements)

References 578 publications

Supporting

Mentioning

314

Contrasting

Unclassified

Order By: Relevance

“…Paroxysmal and persistent AF was defined according to the HRS/EHRA AF guidelines (paroxysmal AF is defined as AF that terminates spontaneously or with intervention within 7 days of onset; persistent AF is defined as continuous AF that is sustained beyond 7 days). 10…”

Section: Patient Populationmentioning

confidence: 99%

Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation

Forkmann

Schwab

Edler

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Aims Early recurrences (ER) of atrial arrhythmias are common after catheter ablation of atrial fibrillation (AF). The significance of these ER is controversial. Based on data of continuous cardiac monitoring, we sought to investigate the characteristics of ER and their impact on late recurrences (LR) during follow‐up. Methods One hundred twenty‐six patients with paroxysmal (49%) or persistent (51%) AF underwent an AF ablation with subsequent implantation of implantable loop recorder. Follow up was 12 months using remote monitoring. All atrial arrhythmia (AF or atrial tachycardia‐AT‐) episodes >30 seconds. within the 3‐month blanking period were considered and the AF burden evaluated every 3 months. Results Within the 3‐months blanking period, 72 patients (57%) experienced an AF/AT recurrence. Survival free from any arrhythmia recurrence during follow‐up was 40% in patients with ER vs 69% in those without ER. AF burden during the blanking period and timing of ER correlated significantly with LR at 12 months (area under curve = 0.74, P < .0001 and .831, P < .0001). An AF burden ≥0.5% and ER after 74 days predicted LR (sensitivity 60%, specificity 84.4%; sensitivity 75.6%, specificity 90.3%). In cox regression analysis, AF burden ≥0.5% and ER after 74 days were independently associated with LR. Conclusion Continuous cardiac monitoring after AF ablation provides important information regarding early recurrence episodes and their prognostic impact. A cut‐off of 74 days for the blanking period seems to better differentiate patients with a good or a poor long‐term outcome. An AF burden ≥0.5% during the 3 months postablation is predictive for late arrhythmia recurrences.

show abstract

Section: Patient Populationmentioning

confidence: 99%

Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation

Forkmann

Schwab

Edler

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…However, based on the Heart Rhythm Society consensus statement classification, there was a significant reduction of severity of PVS mainly driven by a shift from moderate to mild PVS (P = .0001). 12…”

Section: Main Findingsmentioning

confidence: 99%

“…Furthermore, according to the Consensus Statement on catheter and surgical ablation of atrial fibrillation, guidelines for screening, treatment and follow-up of PVS are not yet available. 8,12 Therefore, the aim of the present study was to analyze the natural course of RFA-induced PVS with regard to stenosis grade, clinical symptoms, and mortality after a long-term follow-up. Depending on availability and patients' characteristics, CT or CMR were utilized as the imaging modality of choice for each patient.…”

Section: Introductionmentioning

confidence: 99%

Natural course of acquired pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation—Is routine follow‐up imaging indicated or not?

Schoene

Shamloo

Sommer

et al. 2019

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Introduction Thermal injury during radiofrequency ablation (RFA) of atrial fibrillation (AF) can lead to pulmonary vein stenosis (PVS). The aim of the present study was to analyze the natural course of RFA‐induced PVS with regard to the grade of stenosis, clinical symptoms, and mortality during long‐term follow‐up. Methods and Results All patients with follow‐up imaging for radiofrequency‐induced untreated PVS were retrospectively assessed. From 2004 to 2017, the total rate of PVS following AF ablation in our center was 0.78% (87 of 11 103). Thirty‐eight patients with a total of 54 untreated PVS underwent follow‐up including imaging scan. The mean degree of stenosis at the time of diagnosis was 57% ± 27% vs 45% ± 35% (P = .05) after a mean follow‐up of 43 ± 31 months. There was a shift in severity of the PVS: 18 of 54 (33%) vs 16 of 54 (30%) severe PVS, 19 of 54 (35%) vs 10 of 54 (18%) moderate PVS, and 17 of 54 (32%) vs 28 of 54 (52%) mild PVS (P = .0001). The mean symptom score decreased significantly during follow‐up (1.8 ± 1.0 vs 0.4 ± 0.5, P = .0001). Each of the four patients with progression of PVS underwent another pulmonary vein isolation for AF recurrence following pulmonary vein reconduction during follow‐up period. Conclusion This study showed a spontaneous reduction in stenosis grade and symptoms of PVS over a 3.5‐year follow‐up. Consequently, routine follow‐up imaging of PVS seems not to be necessary. However, additional RF energy delivery to stenotic pulmonary veins should be avoided if possible. In case of conduction recovery, the ablation line should be done wide‐antrally and follow‐up imaging of PVS is recommended.

show abstract

“…Left atrial catheter ablation has lately proven to be a considerable therapeutic option in maintaining sinus rhythm in patients suffering from AF [17]. However, AF catheter ablation has not been yet commonly established in the elderly population [8].…”

Section: Catheter Ablation Of Atrial Fibrillation In the Elderlymentioning

confidence: 99%

Rhythm-control vs rate-control in the elderly: When to do it and which drug to prefer?

Botto¹,

Piemontese

Russo³

2018

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose the elderly to AF. Current therapeutic options such as antiarrhythmic drugs have not been extensively evaluated in the elderly population. Emerging pharmacological and non-pharmacological treatment options for the management of AF, such as dronedarone or catheter ablation, are of particular interest in the elderly. The present paper reviews the pathophysiology, diagnosis, and the management of AF in the elderly patient.

show abstract

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

Cited by 445 publications

References 578 publications

Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation

Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long‐term outcome after atrial fibrillation ablation

Natural course of acquired pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation—Is routine follow‐up imaging indicated or not?

Rhythm-control vs rate-control in the elderly: When to do it and which drug to prefer?

Contact Info

Product

Resources

About