Rhythm monitoring, success definition, recurrence, and anticoagulation after atrial fibrillation ablation

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...

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Detalles Bibliográficos
Autores: Schwab, Ana Carolina|||0000-0002-4746-3112, Anic, Ante|||0000-0002-6864-3999, Farkowski, Michal M|||0000-0003-1673-7712, Guerra Ramos, José María|||0000-0001-5397-9177, Iliodromitis, Konstantinos E|||0000-0003-4243-9823, Jubele, Kristine|||0000-0003-2240-8050, Providência, Rui|||0000-0001-9141-9883, Chun, Julian K R|||0000-0002-2355-6015, Boveda, Serge|||0000-0002-1280-7042
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:272476
Acceso en línea:https://ddd.uab.cat/record/272476
https://dx.doi.org/urn:doi:10.1093/europace/euac194
Access Level:acceso abierto
Palabra clave:Catheter ablation
Rhythm monitoring
Anticoagulation
EHRA survey
Recurrence
Descripción
Sumario: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 CHADS-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.