207: Characteristics of atrial fibrillation ablation in routine practice: In-hospital results of a French registry of more than 1500 procedures

Purpose This atrial fibrillation (AF) ablation registry was conducted in order to describe the current epidemiology of patients undergoing AF ablation, the techniques used and the results obtained in routine practice in France. We report here the in-hospital data. Methods Data were prospectively collected in 6 medium-high volume French centers. All consecutive patients who underwent an atrial fibrillation or a left atrial macro-reentry ablation procedure were included in the registry within a period of 12 to 24 months according to centers. Results From January 2010 to April 2012, 1646 consecutive complex left atrial ablation procedures were collected. Patients were predominantly males (75%) with a mean age of 59.6±10 years old. The targeted arrhythmia was paroxysmal AF in 58%, persistent AF in 32%, long standing AF in 4% or left atrial macro-reentry secondary to a previous AF ablation in 6%. Of interest, redo procedures represented 28% of the overall procedures. Pulmonary vein isolation (PVI) was attempted in 96% of the cases, the roof line in 40% and the left isthmus line in 16%. Complex fractionated atrial electrograms were targeted in 20% of procedures. The procedures were most often performed with an irrigated tip RF ablation catheter (75%) and a 3D navigation system was used in 68% of the procedures. PVI was performed with a cryoballoon in 21% or with phased RF technology tools in 3% of the cases. The mean procedure time was 136±55 min. The overall complication rate was 6.2%. Tamponnade occurred in 23 patients (pts, 1.4%, requiring surgical drainage in 2 pts and responsible of death in 1); stroke was documented in 4 pts (0.3%); phrenic nerve palsy was observed in 8 pts during cryoballoon procedures only (3.7%). Groin hematoma and femoral veno-arterial fistula occurred in 52 pts (3.2%). Atrial-oesophageal fistula documented in 1 pt. Conclusion This prospective registry allows to get a real vision of how and to whom are performed complex left atrial ablation procedures in routine practice. Detailed data analysis might raise potential issues on which preventive action might further reduce procedures complication rate.