Table 1 Results of peer reviewed observational studies of paroxysmal AF ablation.
Study | Patients (n) | SR (%) | Follow up (months) Mean (SD) | Type of AF (%) | Structural heart disease (%) | Technology used | Repeat procedures for quoted success (%) | How SR assessed | Use of antiarrhythmic drugs for quoted success* (%) | Serious complication rate† (%) |
---|---|---|---|---|---|---|---|---|---|---|
Segmental ostial isolation of 4 pulmonary veins | ||||||||||
Haissaguerre et al 2000w28 | 90 | 71 | 8 (5) | 100 paroxysmal | 19 | Circular PV catheter | 54 | Symptoms & “Holter recordings” | 0 | 4.4 |
4 mm RFA | ||||||||||
Fluoroscopy only | ||||||||||
Deisenhofer et al 2003w52 | 75 | 51 | 7.6 (4.4) | 92 paroxysmal.8 persistent | 56 | Circular PV catheter | 40 | Repeated 7 day Holters | Not clearly stated | 10.7 |
4 mm RFA | ||||||||||
Fluoroscopy only | ||||||||||
Marrouche et al 2002w53 | 211 | 79–100 | 4 (2)–10 (3) | 54 paroxysmal,16 persistent,30 permanent | 24 | Circular PV catheter | 0 | “Holter recordings” | Not clearly stated | 3.5 |
4 mm, 8 mm and cooled RFA | “Event recorder considered if symptomatic” | |||||||||
Fluoroscopy only | Recurrences <3 weeks ignored | |||||||||
Tse et al 2003w54 | 52 | 56 | 12 (6) | 87 paroxysmal,13 persistent | 46 | Circular PV catheter | 0 | Event recorders | 38 | 7.7 |
Cryoablation | ||||||||||
Fluoroscopy only | ||||||||||
Oral et al 2002w34 | 70 | 71 paroxysmal,25 persistent | 4.9 (2.6) | 83 paroxysmal,17 persistent | 7 | Circular PV catheter | 9 | Event recorder if symptomatic | 0 | 1.4 |
4 mm RFA | ||||||||||
Fluoroscopy only | ||||||||||
Macle et al 2002w45 | 136 | 66 | 8.8 (5.3) | 90 paroxysmal,10 persistent | 17 | Circular PV catheter | 49 | Not stated | 0 | 0.7 |
Cooled RFA | ||||||||||
Fluoroscopy only | ||||||||||
Wide area circumference ablation of pulmonary veins | ||||||||||
Pappone et al 200114 | 251 | 80 | 10.4 (4.5) | 71 paroxysmal,29 permanent | 14 | Electroanatomical mapping | Not stated | Monthly Holter monitoring | 5 | 0.8 |
RFA (size not stated) | ||||||||||
Pappone et al 2004w31 | 280 | 76 | Not stated | 66 paroxysmal,34 permanent | 42 | Electroanatomical mapping | Not stated | Daily trans telephonic monitoring | Not clearly stated | 0.7 |
8 mm RFA | Monthly Holter monitoring | |||||||||
Recurrences <6 weeks ignored | ||||||||||
Combination of wide area circumferential ablation and isolation of PV catheter | ||||||||||
Ouyang et al 200417 | 41 | 95 | 6 (1) | 100% paroxysmal | Not clearly stated | 2 Circular PV catheters | 22 | Transtelephonic monitoring for asymptomatic patients and regular Holter monitoring | 0 | 0 |
Cooled RFA | ||||||||||
Electroanatomical mapping | ||||||||||
Verma et al 200518 | 700 | 86 paroxysmal,73 non‐paroxysmal | 15.8 (7.8) | 39% paroxysmal,61 non‐paroxysmal | 44 | Circular PV catheter | 0 | Transtelephonic monitoring and regular 48 Holter monitoring Recurrences <2 months ignored | 0‡ | Not stated |
8 mm RFA | ||||||||||
Electroanatomical mapping | ||||||||||
Intracardiac echo |
*Vaughn‐Williams group 1 and 3 only.
†Death, stroke, tamponade, arterial–venous fistula needing repair, pulmonary embolism, phrenic nerve palsy, or ⩾1 pulmonary vein stenosis >50% (or causing symptoms).
‡All patients started on sotalol, propafenone, flecainide, or dofetilide for first 2 months then all stopped.
AF, atrial fibrillation; PV, pulmonary vein; RFA, radiofrequency ablation; SR, sinus rhythm.