Radiofrequency Catheter Ablation Effective for Paroxysmal Atrial Fibrillation, suggests study

The safety and long-term efficacy of radiofrequency (RF) catheter ablation (CA) in treating paroxysmal atrial fibrillation (PAF) has been reaffirmed through a recent study published in the Heart Rhythm journal.

The study utilized data from the REAL-AF (Real-world Experience of Catheter Ablation for the Treatment of Symptomatic Paroxysmal and Persistent Atrial Fibrillation) registry with documentation of RF CA procedures for PAF. This research was conducted across 42 high-volume institutions and involved 79 experienced operators from January 2018 to December 2022. 

The procedures implemented several cutting-edge techniques where over 70% of the procedures avoided the use of fluoroscopy by reducing radiation exposure for both patients and medical staff. Contact Force Sensing Catheters ensure precise catheter contact with the heart tissue by improving ablation accuracy. Also, Wide Area Circumferential Ablation helps isolate the pulmonary veins effectively. Ablation Index with specific targets for different heart regions utilized 380 to 420 for posterior lesions and 500 to 550 for anterior lesions.

Out of 2470 patients, with an average age of 65.2 years and a near-equal gender distribution, the outcomes showed high success rate. At the one-year follow-up, 81.6% of patients remained free from all atrial arrhythmias. Of the patients who achieved arrhythmia-free status, 89.7% were off antiarrhythmic drugs. Also, the average procedure time was 95.4 minutes, with RF application taking around 22.1 minutes. The complication rate was a low 1.9% which underlined the safety of the procedure.

The outcomes of this study suggests that, the modern RF CA techniques for PAF improved by contemporary tools and standardized protocols showed excellent short- and long-term outcomes. The high success rate, minimal complications and reduced reliance on medications highlight the efficacy and safety of this procedure. These findings reinforce RF CA as a robust option for managing PAF by paving the way for broader adoption of these advanced techniques in clinical practice. This research illuminates the continuous improvement in atrial fibrillation treatments which elaborates RF CA as a testament to the progress in cardiovascular medicine for a safer and more effective treatment option.

Source:

Osorio, J., Miranda-Arboleda, A. F., Velasco, A., Varley, A. L., Rajendra, A., Morales, G. X., Hoyos, C., Matos, C., Thorne, C., D’souza, B., Silverstein, J. R., Metzl, M. D., Hebsur, S., Costea, A. I., Kang, S., Sellers, M., Singh, D., Salam, T., Nazari, J., … Zei, P. C. (2024). Real-World Data of Radiofrequency Catheter Ablation in Paroxysmal Atrial Fibrillation: Short- and Long-term Clinical Outcomes from the Prospective Multicenter REAL-AF Registry. In Heart Rhythm. Elsevier BV. https://doi.org/10.1016/j.hrthm.2024.04.090