Half of A.fib patients become asymptomatic after catheter ablation

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Data from the European Heart Rhythm Association reveal high success rates but a concerning lack of appropriate follow-up.

More than half of patients with atrial fibrillation (A.fib) become asymptomatic after catheter ablation, according to new figures from the European Heart Rhythm Association (EHRA).

In an analysis of 3,630 patients in Europe, the Middle East and North Africa, ablation was successful in 74 per cent of patients, with no atrial arrhythmias between three and 12 months after the procedure. But the study also revealed a concerning lack of appropriate monitoring of patients following the procedure.

Post-ablation, patients with two or more stroke risk factors should be prescribed oral anticoagulants. However, the EHRA found that one in four high-risk patients were not receiving anticoagulant therapy. Equally worrying was than one-third of low-risk patients were being anticoagulated, which increases the risk of bleeding. Furthermore, despite recommendations, just 60 per cent of patients underwent serial ECGs and multiday ECG recordings to check for recurrent AF.

“This is a serious issue,” said lead author Dr Elena Arbelo, a senior specialist in the Arrhythmia Unit, Cardiovascular Institute, Hospital Clínic de Barcelona, Spain. “High risk patients who do not receive oral anticoagulation have a greater chance of a stroke. Patients receiving unnecessary treatment are in danger of intracranial and other types of bleeding.”

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