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      Registro Español de Ablación con Catéter. XIX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019) Translated title: Spanish Catheter Ablation Registry. 19th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2019)

      a , * , b , c , en representación de los colaboradores del Registro Español de Ablación con Catéter

      Revista Espanola De Cardiologia

      Sociedad Española de Cardiología. Published by Elsevier España, S.L.U.

      Ablación con catéter, Arritmia, Electrofisiología, Registro, Catheter ablation, Arrhythmia, Electrophysiology, Registry, FA, fibrilación auricular, ICT, istmo cavotricuspídeo, TAF, taquicardia auricular focal, TAM, taquicardia auricular macrorreentrante, TIN, taquicardia intranodular, TVI, taquicardia ventricular idiopática, TV-IAM, taquicardia ventricular relacionada con cicatriz posinfarto, TV-NIAM, taquicardia ventricular asociada con cardiopatía y no relacionada con cicatriz posinfarto

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          Abstract

          Introducción y objetivos

          Se describen los resultados del Registro Español de Ablación correspondientes al año 2019.

          Métodos

          La recogida de datos ha sido retrospectiva mediante la cumplimentación de un formulario de recogida de datos por cada uno de los centros participantes.

          Resultados

          Se han analizado los datos enviados por 102 centros, con un total de 18.549 procedimientos de ablación (el mayor de este registro) y con una media de 181,9 ± 137,0 y una mediana de 144,5 procedimientos por centro. Se consolida la ablación de fibrilación auricular como el sustrato abordado con más frecuencia (n = 5.164; 27,8%), que aumenta la distancia respecto al resto de sustratos. El segundo sustrato es el istmo cavotricuspídeo (n = 3.925; 21,1%) y el tercero, la taquicardia por reentrada intranodular (n = 3.768; 20,3%), desbancada del segundo puesto por aquel. La tasa total de éxito fue de nuevo del 91%; la de complicaciones mayores, del 1,9% y la mortalidad, del 0,03%. Se consolida el uso de navegadores (el 44,5% del total de procedimientos) y de los catéteres con tecnología de contacto en la fibrilación auricular (84,8%) y la taquicardia ventricular (90%). El 1,5% de las ablaciones se realizaron en pacientes pediátricos.

          Conclusiones

          El Registro Español de Ablación recoge de manera sistemática sin interrupción los procedimientos de ablación realizados en España, y permite observar a lo largo de los años un aumento progresivo del número de ablaciones manteniendo una alta tasa de éxito y unos porcentajes bajos de complicaciones.

          Translated abstract

          Introduction and objectives

          This report presents the findings of the 2019 Spanish Catheter Ablation Registry.

          Methods

          Data collection was retrospective. A standardized questionnaire was filled by each of the participant centers.

          Results

          Data sent by 102 centers were analyzed, with a total number of ablation procedures performed of 18 549 (the highest historically reported in this registry) for a mean of 181.9 ± 137.0 and a median of 144.5 procedures per center. The ablation targets most frequently treated were atrial fibrillation (n = 5164; 27.8%), cavotricuspid isthmus (n = 3925; 21,1%) and atrioventricular nodal reentrant tachycardia (n = 3768; 20,3%). A new peak is observed in the ablation of atrial fibrillation, increasing the distance from the other substrates. The overall success rate was again 91%. The rate of major complications was 1.9%, and the mortality rate was 0.03%. An electroanatomic mapping system was used in 44.5% of all procedures, with contact force-sensing irrigated catheters become the preferred for complex substrates, as atrial fibrillation (84,8%) or ventricular tachycardia (around 90%). 1.5% of the ablations were performed in pediatric patients.

          Conclusions

          The Spanish Catheter Ablation Registry enrolls systematically and uninterruptedly the ablation procedures performed in Spain, showing a progressive increasing in the number of ablations over the years with a high success rate and low percentages of complications.

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          Most cited references 27

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          Long-term symptom improvement and patient satisfaction following catheter ablation of supraventricular tachycardia: insights from the German ablation registry.

          To analyse outcomes of supraventricular tachycardia (SVT) ablations performed within a prospective German Ablation Quality Registry.
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            German ablation registry: Cryoballoon vs. radiofrequency ablation in paroxysmal atrial fibrillation--One-year outcome data.

            Although radiofrequency (RF) ablation has long been the standard of care for atrial fibrillation (AF) ablation, cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation are lacking so far.
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              Is Open Access

              A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes

              Abstract Aims Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing ‘real-world’ data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported. Methods and Results Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff–Parkinson–White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7–7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%). Conclusion Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.
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                Author and article information

                Journal
                Rev Esp Cardiol
                Rev Esp Cardiol
                Revista Espanola De Cardiologia
                Sociedad Española de Cardiología. Published by Elsevier España, S.L.U.
                0300-8932
                1579-2242
                23 September 2020
                23 September 2020
                Affiliations
                [a ]Unidad de Arritmias, Hospital General Universitario de Valencia, Valencia, España
                [b ]Unidad de Arritmias, Hospital Virgen Macarena, Sevilla, España
                [c ]Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
                Author notes
                [* ]Autor para correspondencia: Unidad de Arritmias, Servicio de Cardiología, Hospital General Universitario de Valencia, Avda. Tres Cruces 2, 46014 Valencia, España.
                [◊]

                La lista completa de colaboradores se incluye en el anexo 1.

                Article
                S0300-8932(20)30479-6
                10.1016/j.recesp.2020.08.005
                7509535
                © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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