Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry
BackgroundCatheter ablation (CA) for symptomatic atrial fibrillation (AF) offers the best outcomes for patients. Despite the benefits of CA, a significant proportion of patients suffer a recurrence; hence, there is scope to potentially improve outcomes through technical innovations such as ablation...
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| Format: | Article |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1332868/full |
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| author | N. Fitzpatrick S. Herczeg K. Hong F. Seaver L. Rosalejos U. Boles U. Boles G. Jauvert E. Keelan J. O’Brien T. Tahin J. Galvin J. Galvin G. Széplaki G. Széplaki |
| author_facet | N. Fitzpatrick S. Herczeg K. Hong F. Seaver L. Rosalejos U. Boles U. Boles G. Jauvert E. Keelan J. O’Brien T. Tahin J. Galvin J. Galvin G. Széplaki G. Széplaki |
| author_sort | N. Fitzpatrick |
| collection | DOAJ |
| description | BackgroundCatheter ablation (CA) for symptomatic atrial fibrillation (AF) offers the best outcomes for patients. Despite the benefits of CA, a significant proportion of patients suffer a recurrence; hence, there is scope to potentially improve outcomes through technical innovations such as ablation index (AI) guidance during AF ablation. We present real-world 5-year follow-up data of AI-guided pulmonary vein isolation.MethodsWe retrospectively followed 123 consecutive patients who underwent AI-guided CA shortly after its introduction to routine practice. Data were collected from the MPH AF Ablation Registry with the approval of the institutional research board.ResultsOur patient cohort was older, with higher BMI, greater CHA2DS2-VASc scores, and larger left atrial sizes compared to similar previously published cohorts, while gender balance and other characteristics were similar. The probability of freedom from atrial arrhythmia with repeat procedures is as follows: year 1: 0.95, year 2: 0.92, year 3: 0.85, year 4: 0.79, and year 5: 0.72. Age >75 years (p = 0.02, HR: 2.7, CI: 1.14–6.7), BMI >35 kg/m2 (p = 0.0009, HR: 4.6, CI: 1.8–11.4), and left atrial width as measured on CT in the upper quartile (p = 0.04, HR: 2.5, CI: 1–5.7) were statistically significant independent predictors of recurrent AF.ConclusionAI-guided CA is an effective treatment for AF, with 95.8% of patients remaining free from atrial arrhythmia at 1 year and 72.3% at 5 years, allowing for repeat procedures. It is safe with a low major complication rate of 1.25%. Age >75 years, BMI >35 kg/m2, and markedly enlarged atria were associated with higher recurrence rates. |
| first_indexed | 2024-03-08T13:50:02Z |
| format | Article |
| id | doaj.art-1d904ece6857474f9a999ca2c7200a47 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-08T13:50:02Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-1d904ece6857474f9a999ca2c7200a472024-01-16T04:36:58ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-01-011010.3389/fcvm.2023.13328681332868Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation RegistryN. Fitzpatrick0S. Herczeg1K. Hong2F. Seaver3L. Rosalejos4U. Boles5U. Boles6G. Jauvert7E. Keelan8J. O’Brien9T. Tahin10J. Galvin11J. Galvin12G. Széplaki13G. Széplaki14Atrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandDepartment of Cardiology, Heart and Vascular Centre of Semmelweis University, Budapest, HungaryHealth Sciences Centre, UCD School of Medicine, University College Dublin, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandDepartment of Medicine, Royal College of Surgeons in Ireland, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandHealth Sciences Centre, UCD School of Medicine, University College Dublin, Dublin, IrelandAtrial Fibrillation Institute, Mater Private Hospital, Dublin, IrelandDepartment of Medicine, Royal College of Surgeons in Ireland, Dublin, IrelandBackgroundCatheter ablation (CA) for symptomatic atrial fibrillation (AF) offers the best outcomes for patients. Despite the benefits of CA, a significant proportion of patients suffer a recurrence; hence, there is scope to potentially improve outcomes through technical innovations such as ablation index (AI) guidance during AF ablation. We present real-world 5-year follow-up data of AI-guided pulmonary vein isolation.MethodsWe retrospectively followed 123 consecutive patients who underwent AI-guided CA shortly after its introduction to routine practice. Data were collected from the MPH AF Ablation Registry with the approval of the institutional research board.ResultsOur patient cohort was older, with higher BMI, greater CHA2DS2-VASc scores, and larger left atrial sizes compared to similar previously published cohorts, while gender balance and other characteristics were similar. The probability of freedom from atrial arrhythmia with repeat procedures is as follows: year 1: 0.95, year 2: 0.92, year 3: 0.85, year 4: 0.79, and year 5: 0.72. Age >75 years (p = 0.02, HR: 2.7, CI: 1.14–6.7), BMI >35 kg/m2 (p = 0.0009, HR: 4.6, CI: 1.8–11.4), and left atrial width as measured on CT in the upper quartile (p = 0.04, HR: 2.5, CI: 1–5.7) were statistically significant independent predictors of recurrent AF.ConclusionAI-guided CA is an effective treatment for AF, with 95.8% of patients remaining free from atrial arrhythmia at 1 year and 72.3% at 5 years, allowing for repeat procedures. It is safe with a low major complication rate of 1.25%. Age >75 years, BMI >35 kg/m2, and markedly enlarged atria were associated with higher recurrence rates.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1332868/fullatrial fibrillationpulmonary vein isolation (PVI)catheter ablationablation indexlong-term follow-up |
| spellingShingle | N. Fitzpatrick S. Herczeg K. Hong F. Seaver L. Rosalejos U. Boles U. Boles G. Jauvert E. Keelan J. O’Brien T. Tahin J. Galvin J. Galvin G. Széplaki G. Széplaki Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry Frontiers in Cardiovascular Medicine atrial fibrillation pulmonary vein isolation (PVI) catheter ablation ablation index long-term follow-up |
| title | Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry |
| title_full | Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry |
| title_fullStr | Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry |
| title_full_unstemmed | Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry |
| title_short | Long-term results of ablation index guided atrial fibrillation ablation: insights after 5+ years of follow-up from the MPH AF Ablation Registry |
| title_sort | long term results of ablation index guided atrial fibrillation ablation insights after 5 years of follow up from the mph af ablation registry |
| topic | atrial fibrillation pulmonary vein isolation (PVI) catheter ablation ablation index long-term follow-up |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1332868/full |
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