- High success rates with catheter ablation
- Catheter ablation may provide benefits over long-term pharmacological therapy in terms of Afib-free and overall survival
- Randomized, controlled clinical studies demonstrate the benefits of catheter ablation over more traditional therapies
- Radiofrequency catheter ablation is considered safe
- Catheter ablation is cost effective compared to pharmacological therapy
High success rates with catheter ablation
Reviewing the increasing body of published data, the overall success rate of radiofrequency catheter ablation is around 80% considering Afib-free survival at one year as the endpoint (ref. 18). While it is true that follow-up times have generally been limited to 12 months in most studies,some have followed up patients for much longer. In terms of efficacy,what has emerged is that recurrence of Afib is likely to be an early event, occurring within the first few weeks following ablation. In its absence, the arrhythmia generally does not recur even after long-follow up periods (ref. 19). Thus, catheter ablation has been considered by many as a potentially curative therapy (ref. 14, 15).
Variations in success rates observed are likely due to the diverse mechanisms at the basis of Afib and the fact that some patients may respond better to simple ablation of the pulmonary veins, while others with multiple reentrant circuits may necessitate more extensive ablation in order to eliminate anomalous electrophysiological activity. Significant advances have been made in determining the most appropriate ablation strategy for patients, leading to an increase in success rates
Figure: Afib-free survival of patients experiencing early recurrence compared to those that do not. Oral et al. (ref. 19).