A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes

Research output: Contribution to journalArticle

Abstract

AIMS: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. METHODS AND RESULTS: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%). CONCLUSION: Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.

Details

Authors
  • Fredrik Holmqvist
  • Milos Kesek
  • Anders Englund
  • Carina Blomström-Lundqvist
  • Lars O. Karlsson
  • Göran Kennebäck
  • Dritan Poçi
  • Romeo Samo-Ayou
  • Runa Sigurjónsdóttir
  • Michael Ringborn
  • Csaba Herczku
  • Jonas Carlson
  • Espen Fengsrud
  • Fariborz Tabrizi
  • Niklas Höglund
  • Stefan Lönnerholm
  • Ole Kongstad
  • Anders Jönsson
  • Per Insulander
Organisations
External organisations
  • Norrland University Hospital
  • Uppsala University Hospital
  • Linköping University Hospital
  • Karolinska University Hospital
  • Örebro University Hospital
  • Sahlgrenska University Hospital
  • Blekinge Hospital
  • Norra Älvsborgs Länssjukhus
  • Skåne University Hospital
  • Karolinska Institutet
  • Skaraborg Hospital
  • Södersjukhuset
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Adverse events, Catheter ablation, Outcome
Original languageEnglish
Pages (from-to)820-830
Number of pages11
JournalEuropean Heart Journal
Volume40
Issue number10
Publication statusPublished - 2019
Publication categoryResearch
Peer-reviewedYes