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Atrial fibrillation ablation: is common practice far from guidelines’ world? The Italian experience from a national survey

Journal of Interventional Cardiac Electrophysiology volume 63, pages 125–132 (2022)Cite this article

Abstract

Purpose

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population. Catheter ablation has become an important treatment modality for patients with symptomatic drug-refractory AF. We report data regarding the AF ablation approaches and modalities in the Italian “real world.”

Methods

The survey was set-up to collect data on ablation procedure across Italy. All centers performing AF ablation were invited, regardless of the number of annual procedures, to complete a questionnaire regarding their ablation approaches. All centers reported data regarding procedures performed during the year 2017.

Results

A total of 3260 procedures were reported from 49 participating hospitals. Most of Italian regions were included in the study. The majority of the centers performed “Always” pulmonary vein isolation (PVI) in paroxysmal and persistent AF catheter ablation, while adjunctive lesions in persistent AF ablation were planned in most of them but not all, and 16% never performed lesions other than PVI. During ablation procedure, vitamin k inhibitors were uninterrupted in 55% of centers, while direct oral anticoagulant in 44% of centers was used uninterruptedly. No relationship was observed between patient data and the number of procedures performed at each center.

Conclusions

This survey suggests that the adherence of Italian centers to the most recent European Society of Cardiology guidelines for AF ablation is reasonably high.

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Author notes

  1. Gemma Pelargonio and Antonio Di Monaco contributed equally to this work.

Authors and Affiliations

  1. Dipartimento di Scienze Cardiovascolari Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy

    Gemma Pelargonio & Maria Lucia Narducci

  2. Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy

    Gemma Pelargonio

  3. Dipartimento di Cardiologia. Ospedale Generale Regionale “F. Miulli”, Acquaviva delle Fonti (Bari), Italy

    Antonio Di Monaco, Pietro Guida & Massimo Grimaldi

  4. Dipartimento di Cardiologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Foggia, Foggia, Italy

    Pier Luigi Pellegrino

  5. Unità Operativa di Aritmologia, Ospedale San Raffaele di Milano, Segrate, Italy

    Pasquale Vergara

  6. Unità operativa di Elettrofisiolgia ed Elettrostimolazione, Humanitas Mater Domini, Castellanza (Varese), Italy

    Massimo Tritto

Authors
  1. Gemma Pelargonio
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  2. Antonio Di Monaco
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  3. Pietro Guida
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  4. Pier Luigi Pellegrino
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  5. Pasquale Vergara
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  6. Massimo Grimaldi
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  7. Maria Lucia Narducci
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  8. Massimo Tritto
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Consortia

AIAC Task Force AF Ablation

Corresponding author

Correspondence to Antonio Di Monaco.

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AIAC membership: all the authors are AIAC members. Pelargonio and Tritto are chiefs of AIAC Task Force AF Ablation

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Pelargonio, G., Di Monaco, A., Guida, P. et al. Atrial fibrillation ablation: is common practice far from guidelines’ world? The Italian experience from a national survey. J Interv Card Electrophysiol 63, 125–132 (2022). https://doi.org/10.1007/s10840-021-00955-7

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  • DOI: https://doi.org/10.1007/s10840-021-00955-7

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Registry
  • Italy