The complication rate is higher than hoped, and the success rate is lower than hoped, he said.
“Patients don’t get a lifetime certificate saying you’re cured,” Calkins said. “For one in four patients, atrial fibrillation comes back five years after the procedure. Patients should not be going into this thinking they will have a 99 percent cure rate with no risk,” he added.
The new study included information from more than 3,600 patients in Europe, the Middle East and North Africa. Their average age was 59, and all had undergone catheter ablation.
Ablation was successful in 74 percent of patients, Arbelo said. These patients had no atrial arrhythmias — irregular heart beats — for three to 12 months after the procedure.
According to Arbelo, 91 percent of patients choose to have ablation to relieve symptoms, while 66 percent do so to improve their quality of life.
Atrial arrhythmias in the first three months after ablation were classified as early recurrences and not considered as failures, Arbelo said. In addition, 45 percent of patients who had a successful procedure were still taking antiarrhythmia drugs 12 months later.
About 11 percent suffered complications during the year after the ablation, she said.
The study investigators found that 27 percent of patients with two or more risk factors for stroke were not on blood thinners, but one-third of low-risk patients were taking them.
Dr. Gregg Fonarow is a professor of cardiology at the University of California, Los Angeles. He said, “Relief of symptoms in patients with atrial fibrillation can be challenging.”
In certain patients, catheter ablation may reduce symptoms, improve quality of life and increase exercise capacity, though the impact on death and hospitalization risk is still being evaluated, he noted.
“Of concern is that complication rates are still higher than desirable for this procedure, and there was suboptimal use of stroke-preventing anticoagulation [anti-clotting] therapy after the procedure,” added Fonarow, who was not involved with the study.