Article Impact Level: HIGH Data Quality: STRONG Summary of Europace, 26(4), euae043. https://doi.org/10.1093/europace/euae043 Dr. Stylianos Tzeis et al.
Points
- A consensus statement in EP Europace provides recommendations for catheter ablation of atrial fibrillation (AF) based on international collaboration and expert input.
- Emphasizes the importance of a healthy lifestyle to reduce AF risk and lower recurrences while highlighting the benefits of catheter ablation as a first-line treatment for symptomatic patients with recurrent AF.
- Outlines essential pre-procedural assessments, including electrocardiogram and echocardiogram, and the potential need for computed tomography or transesophageal echocardiography to exclude blood clots.
- Recommends uninterrupted blood thinner use before catheter ablation and provides specific instructions regarding medication continuation for patients, along with anticoagulation for at least two months after the procedure.
- Reflects the evolving landscape of catheter and surgical AF ablation, representing a collaborative effort from leading cardiac electrophysiology societies to provide updated guidance for healthcare professionals involved in AF ablation.
Summary
The consensus statement, published in EP Europace and coinciding with the annual meeting of the European Heart Rhythm Association, provides comprehensive recommendations for the catheter ablation of atrial fibrillation (AF). Stylianos Tzeis, Ph.D., and colleagues from Mitera Hospital in Athens, Greece, developed an international consensus on treating AF with catheter or surgical ablation. The document emphasizes the importance of a healthy lifestyle to reduce the risk of developing AF and reduce recurrences. It also highlights the benefits of catheter ablation as a first-line treatment for symptomatic patients with recurrent paroxysmal or persistent AF who are resistant or intolerant to antiarrhythmic drugs, as well as for patients with AF and heart failure.
The consensus statement outlines the essential pre-procedural assessments, including electrocardiogram and echocardiogram, and the potential need for computed tomography or transesophageal echocardiography to exclude the presence of a blood clot. It emphasizes the importance of uninterrupted blood thinner use before catheter ablation and provides patients with specific instructions regarding medication continuation. Additionally, the document recommends anticoagulation for at least two months after the procedure, with the potential need for prolonged anticoagulation based on clot risk. Antiarrhythmic drugs are advised for some patients to prevent arrhythmia recurrences early after the procedure. The statement also addresses the rarity of complications after catheter ablation, with an extremely low risk of death (0.05 to 0.1 percent).
The consensus statement reflects the evolving landscape of catheter and surgical AF ablation, necessitating a contemporary patient selection and management framework. It represents a collaborative effort from leading cardiac electrophysiology societies, including the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society, to provide updated guidance for healthcare professionals involved in AF ablation.
Link to the article: https://academic.oup.com/europace/article/26/4/euae043/7639428
References Tzeis, S., Gerstenfeld, E. P., Kalman, J., Saad, E. B., Sepehri Shamloo, A., Andrade, J. G., Barbhaiya, C. R., Baykaner, T., Boveda, S., Calkins, H., Chan, N.-Y., Chen, M., Chen, S.-A., Dagres, N., Damiano, R. J., De Potter, T., Deisenhofer, I., Derval, N., Di Biase, L., … Trines, S. A. (2024). 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace, 26(4), euae043. https://doi.org/10.1093/europace/euae043
