The HRS Expert Consensus Statement also states that all ablation trials should report the success rates following a single ablation procedure without using antiarrhythmic medications, using a minimum of 12 months follow-up. Any afib activity during that blanking period is not counted in a study’s results.Īfter the blanking period, the HRS Expert Consensus Statement defines success as “freedom from afib, atrial flutter or tachycardia” greater than 30 seconds and discontinuation of antiarrhythmic medication as the gold standard for reporting the success rates of afib ablation. Immediately after the procedure, there is a three-month “blanking period” during which time atrial fibrillation episodes can occur due to the inflammation that the body produces in response to the procedure. The HRS Expert Consensus Statement set guidelines for catheter ablation trials. Mellanie True Hills Founder & CEO, Measuring Catheter Ablation Success For example, the type of afib (longstanding persistent atrial fibrillation), the presence of structural heart disease in addition to having afib, and the presence of risk factors such as obesity and sleep apnea have all been associated with the recurrence of atrial fibrillation after catheter ablation procedures. It is also important to understand that ablation success rates can vary by individual. Some centers today cite success rates of 80%–85% for first ablations and 95% for second ablations, but there are variances in how different centers measure success. Since the second worldwide survey used data on procedures only up until 2006, safety and efficacy should be expected to be higher today using current procedures and experience rates, particularly in high-volume centers. Similarly, only 20% of centers in the first survey treated patients with longstanding persistent atrial fibrillation, which increased to 47% of centers in the second worldwide survey. In the first survey, only 53% of centers performed catheter ablation on patients with persistent atrial fibrillation, whereas in the second, 86% of centers treated persistent afib. The second worldwide survey showed that doctors were starting to treat more patients with persistent and longstanding persistent atrial fibrillation with catheter ablation. When broken down by type of afib, the success rate without antiarrhythmic drugs was 75% for paroxysmal afib, 65% for persistent afib, and 63% for longstanding persistent afib. More than one ablation procedure was needed to achieve these success rates, but the second survey did not indicate what percentage of patients had second and third procedures. That means that only 10% of patients in the second survey had to remain on antiarrhythmic drugs vs. The overall success rate, which included patients who continued to take antiarrhythmic drugs, was 80% in the second survey vs. The success rate was 70% without antiarrhythmic drugs vs. The second worldwide multicenter survey, on catheter ablations performed from 2003–2006, was subsequently published and showed an improvement in treatment success. Success rates were highest in high-volume centers. Achieving this success required a second procedure for 24.3%, and a third procedure for 3.1%. For many, those drugs did not work prior to the ablation. An additional 23.9% were successful but were on antiarrhythmic drugs. ![]() It indicated that 52% of patients having an atrial fibrillation catheter ablation were successful and symptom-free without antiarrhythmic drugs. In 2005, the first worldwide multicenter survey on catheter ablation was published using data from 181 centers from 1995–2002. 1 Outcomes varied based on differences in technique, experience, skill, and follow-up. For multiple procedures, the majority reported success rates of 70% or more for paroxysmal atrial fibrillation and 50% or more for persistent atrial fibrillation. In early studies, the majority of centers reported single procedure success rates of 60% or more for paroxysmal atrial fibrillation and 30% or less for persistent atrial fibrillation. Catheter ablation success rates have improved over time based on a better understanding of atrial fibrillation, new techniques and technology, and greater doctor experience.
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