Welcome to our 8th ablation survey. Previous surveys dealt mainly with the immediate success of catheter ablations or surgical procedures. This 2013 survey and the previous two surveys (2009 and 2011), however, focus on the long-term success. Long-term success in the case of catheter ablations for lone AF is a relative term since these procedures did not become common until about 10 years ago.

A total of 54 respondents who had undergone their final procedure prior to November 2005 participated in the 2013 survey. The majority of procedures reported (99%) were radiofrequency catheter ablations. Of the 54 respondents undergoing RF ablation, 32 (59%) underwent a single procedure, while 22 (41%) underwent 2 or more procedures for the purpose of curing AF. The most widely used and most successful procedure for paroxysmal AF was the pulmonary vein antrum isolation procedure developed by Dr. Andrea Natale and the segmental pulmonary vein isolation procedure (Haissaguerre protocol), which was also especially successful among permanent afibbers.

The most important variable determining long-term success was whether or not a respondent had an initially successful procedure, i.e. remained in sinus rhythm without the use of antiarrhythmics during the last 6 months of the 12-month period following their final procedure (index period). The long-term prognosis for an afib-free future without the use of antiarrhythmic drugs after an initially successful catheter ablation is excellent with 88% of paroxysmal afibbers and 80% of permanent afibbers being in this enviable state 8 years after their final procedure. In comparison, in the initially unsuccessful group only 40% of paroxysmal afibbers and 50% of permanent afibbers achieved this status.

At year 4 the afib burden and percent time spent in afib were reduced by an average (median) of 98% over the pre-ablation burden among paroxysmal afibbers whose ablation had not been successful. This was reflected in a 97% reduction in impact on quality of life. The reduction in afib burden and percent time spent in afib were also reduced in year 8 as compared to pre-ablation values; however, the reduction (80%) was no longer statistically significant, but the reduction in impact on quality of life (88%) remained statistically significant. These findings may indicate that, while an unsuccessful ablation still results in a significantly lower afib burden and improved quality of life in paroxysmal afibbers at the 4 year mark, the beneficial effects of the ablation may begin to wear off at the 8 year mark.

Only 3 permanent afibbers had provided data for pre-ablation and year 8. Average reductions in afib burden and percent time spent in afib were close to 100% and reduction in impact on quality of life was 99%. Last but not least, if you need to restock your supplements, please remember that by ordering through my on-line vitamin store you will be helping to defray the cost of maintaining the web site and bulletin board. You can find the store at http://www.afibbers.org/vitamins.htm - your continuing support is greatly appreciated.

Wishing you good health and lots of NSR,