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Catheter Ablations Work! Long-Term Success Rate is 87% after Ten Years!

Catheter Ablation: Long Term Success for Atrial Fibrillation patients, A-Fib, a fib, afib

Catheter Ablation: Long Term Success

By Steve S. Ryan, PhD

Great news for A-Fib and catheter ablation patients! The research results are in from a ten-year follow-up of Atrial Fibrillation patients receiving catheter ablations (PVAI). Doctors at the Texas Cardiac Arrhythmia Institute in Austin, TX, ablated for paroxysmal A-Fib. After ten years 87% were still A-Fib free, though some needed two ablations.

Note: The doctors in Austin performed more extensive ablations than most centers at that time, and also performed empiric isolation of the superior vena cava in all patients.

Of the 513 patients, 59% needed only one ablation, while 28% required two. Reconnection in the pulmonary vein antrum was the main reason for having a “repeat” (or second) ablation. This reconnection was found in 31% of patients at the time of their first “repeat” procedure and in no patients who underwent a second repeat (third) ablation.

What about patients who had recurrent A-Fib after two ablations? They were given a high-dose isoproterenol treatment to identify non-pulmonary vein triggers, which were then targeted with a second “repeat” (third) ablation.

Ten-Year Follow-up & Monitoring Follow-up, including Holter monitoring, was performed every 3 months during year 1 and every 6-9 months thereafter. The rate of recurrent A-Fib was 21% at 1 year and 11% during years 1-3. During years 3-6 of follow-up, there was a low 4% recurrence rate. Between years 6-10, the recurrence rate was 5%. [This is in contrast with previous studies which found an approximately 7% yearly rate of late recurrence.]

Editor’s Comments:
Take note you nay-sayers who claim that catheter ablations don’t last (I’ve been A-Fib free for 16 years) or that we don’t have any long-term data about catheter ablation!
Though this is a study from only one center, the conclusion is clear: Catheter ablations done right do work. An 87% success rate after ten years for paroxysmal A-Fib is a milestone result and great news for A-Fib patients.
Yes, it may require a “repeat” procedure. But so do many other heart-related procedures (stents, for example). As a former A-Fib patient, I can say confidently that years of being A-Fib free is worth it, even if you have to go in for a “touchup” procedure.
What does this mean for today’s A-Fib patients?
This 10-year study followed patients who received their ablation between 2000 and 2002. Over the past 12 years, think about the significant improvements in catheter ablation techniques, use of technologies to increase safety, novel catheter designs and navigation technologies and higher resolution imaging techniques.
With over a decade of advancements, today’s patients should have even better outcomes.
(You may also want to read my article about how high volume centers have the lowest complication rates: Considering a Catheter Ablation? Know Complication Rates When Choosing Your Doctor.)
References for this Article
• Jancin, Bruce. Ten-year outcomes for ablation in atrial fibrillation impressive. Family Practice News Digital Network, January 5, 2014.

• Santangeli, P. A retrospective case series involving 513 patients who underwent pulmonary vein antrum isolation during 2000-2002 at a single high-volume center. American Heart Association scientific sessions. Dallas, TX, Nov 2013.

• Van Slooten, Travis. Ablations Have 87% Success Rate After 10 Years. Afib News & Research. Living with Atrial Fibrillation. January 27, 2014.

Posted October 2014

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Last updated: Sunday, February 15, 2015

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