{
  "abstract": "Introduction Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and can be associated with substantial symptom burden, including palpitations, breathlessness, fatigue and chest pain. It is also linked to major cardiovascular complications such as stroke and heart failure, as well as increased all-cause mortality. 1 Catheter ablation can reduce AF recurrence and improve quality of life in symptomatic patients who are intolerant of, or refractory to, anti-arrhythmic drugs. Furthermore, it is increasingly considered a first-line strategy in patients with paroxysmal AF.2Objectives We aimed to evaluate the success, recurrence and complication rates of AF ablation over a one-year period and compare it against reported data from large European trials. Furthermore, we examined the impact of different ablation technologies in a real-world UK cohort to inform future service development and quality improvement.Methods A retrospective analysis was performed on AF ablation procedures from January 1, 2018, to December 31, 2018, at Royal Papworth Hospital, a specialist heart and lung tertiary centre in the UK. Only index ablations were included, redo procedures were excluded. Patients in 2018 were selected to allow a sufficiently long follow-up period. Data were collected from the Tomcat electronic system and crosschecked with data from January 2018 to December 2024 within the Lorenzo procedure notes, discharge summaries, and clinic letters available in the electronic medical record (EMR). The primary objectives were to audit AF ablations and determine the success, recurrence and complication rates, both overall and between each technology.Results 500 index ablations were performed in 2018 with a mean patient age of 62 years (range 27–87); 356 (71%) were male, 144 (29%) were female. 312 (62%) underwent ablation for persistent atrial fibrillation, 185 (37%) for paroxysmal atrial fibrillation and 3 (1%) were unknown. 244 (49%) of cases used Cryoballoon ablation, 197 (39%) used Radiofrequency (RF) ablation, 50 (10%) used Pulmonary Vein Ablation Catheter (PVAC), and 9 (2%) unknown. 66.3% of patients had clinical improvement post-ablation, 28.2% had no clinical improvement, and 5.5% unknown. Recurrence of AF or atrial tachycardia occurred in 243 (49%) patients, 236 (47%) had no recurrence, and it was unknown in 21 (4%). Comparing the ablation procedures, recurrence occurred in 119 (49%), 96 (49%) and 27 (54%) for Cryo ablation, RF ablation, and PVAC, respectively. Overall, six per cent of ablations led to complications, with 5 patients (1%) developing pericarditis and 5 patients (1%) developing tamponade. Our centre had lower complication rates than those reported in the FIRE AND ICE study (2016). 3Conclusion This study offers valuable insights into AF ablation outcomes in a real-world UK setting. This work supports future local comparative studies of emerging technologies, such as pulsed field ablation (PFA). Furthermore, it informs ongoing quality improvement initiatives to refine follow-up care strategies, enable earlier detection of AF recurrence, optimise long-term patient management, and ultimately enhance patient outcomes.References Chung SC, Sofat R, Acosta-Mena D, Taylor JA, Lambiase PD, Casas JP, Providencia R. Atrial fibrillation epidemiology, disparity and healthcare contacts: a population-wide study of 5.6 million individuals. Lancet Reg Health Eur. 2021;7:100157.2024 ESC Guidelines for the management of atrial fibrillation. ESC Clinical Practice Guidelines. https://doi.org/10.1093/eurheartj/ehae176Kuck KH, Fürnkranz A, Chun KR, Metzner A, Ouyang F, Schlüter M, Elvan A, Lim HW, Kueffer FJ, Arentz T, Albenque JP, Tondo C, Kühne M, Sticherling C, Brugada J; FIRE AND ICE Investigators. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J. 2016. 7;37(38):2858–2865.",
  "authors": [
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Deepika Seeboruth"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Alastair Watson"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Scarlett Mattingly-Peck"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Amjad Algharaibeh"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Anusha Singh"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Myo Zaw"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, United Kingdom"
      ],
      "name": "Simon Fynn"
    }
  ],
  "title": "217 Atrial fibrillation ablation outcomes at a tertiary specialist heart and lung centre, royal Papworth Hospital",
  "uid": "93071fa8-29bf-56de-8a36-178d0902ec25"
}