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Guidelines Developed for Catheter Ablation of Atrial Fibrillation

Medically reviewed by Carmen Pope, BPharm. Last updated on April 10, 2024.

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 10, 2024 -- In a consensus statement published in the April issue of EP Europace to coincide with the annual meeting of the European Heart Rhythm Association, held from April 7 to 9 in Berlin, recommendations are presented for the catheter ablation of atrial fibrillation.

Stylianos Tzeis, Ph.D., from Mitera Hospital in Athens, Greece, and colleagues developed an international consensus statement on treatment of atrial fibrillation with catheter or surgical ablation.

The authors note that to reduce the risk for developing atrial fibrillation and lower the number of recurrences, a healthy lifestyle is advised. For patients with symptoms and recurrent atrial fibrillation, catheter ablation is beneficial as first-line treatment. Benefits are also seen for symptomatic patients with recurrent paroxysmal or persistent atrial fibrillation who are resistant or intolerant to one or more antiarrhythmic drugs and for patients with atrial fibrillation and heart failure. Patients should have an electrocardiogram and echocardiogram before the procedure; to exclude presence of a blood clot, some patients require computed tomography or transesophageal echocardiography. Blood thinners should not be interrupted before catheter ablation; specific instructions regarding medication continuation should be provided to patients. All patients should receive anticoagulation for at least two months after the procedure. Prolonged anticoagulation may be needed depending on clot risk. To prevent arrythmia recurrences early after the procedure, antiarrhythmic drugs are advised for some patients. Complications are uncommon after catheter ablation; the risk for death is extremely low (0.05 to 0.1 percent).

"Ablation is the most effective way to prevent recurrences of atrial fibrillation and delay progression to more advanced forms," Tzeis said in a statement.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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