Elsevier

Heart Rhythm

Volume 14, Issue 10, October 2017, Pages e275-e444
Heart Rhythm

News from the Heart Rhythm Society
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

https://doi.org/10.1016/j.hrthm.2017.05.012Get rights and content
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Keywords

Ablation
Arrhythmia
Atrial fibrillation
Atrial flutter
Atrial tachycardia
Catheter ablation
Surgical ablation
Stroke
Anticoagulation

Abbreviations

3D
three-dimensional
AADs
antiarrhythmic drugs
AATAC
Ablation vs Amiodarone for Treatment of Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted ICD/CRTD
ACE
asymptomatic cerebral emboli
ACT
activated clotting time
ADVICE
Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination study
AEF
atrial esophageal fistula
AF
atrial fibrillation
AFACART
Non-Invasive Mapping of Atrial Fibrillation study
AFACT
Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery study
AFCL
atrial fibrillation cycle length
AFEQT
Atrial Fibrillation Effect on QualiTy-of-Life questionnaire
AFL
atrial flutter
AH
arterial hypertension
ANS
autonomic nervous system
APD
action potential duration
ARREST-AF
Aggressive Risk Factor Reduction Study for Atrial Fibrillation and Implications for the Outcome of Ablation study
ASD
atrial septal defect
ASTA
Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia
AT
atrial tachycardia
ATA
atrial tachyarrhythmia
ATP
adenosine triphosphate
AV
atrioventricular
AVR
aortic valve replacement
BIFA
box isolation of fibrotic areas
BMI
body mass index
BP
blood pressure
bpm
beats per minute
BSM
body surface mapping
CABANA
Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial
CABG
coronary artery bypass grafting
CaMKII
Ca2+/calmodulin-dependent protein kinase II
CB
cryoballoon
CBA
cryoballoon ablation
CF
contact force
CFAE
complex fractionated atrial electrogram
CFS
contact force sensing
CGCI
Catheter Guidance, Control, and Imaging
CHASE-AF
Catheter Ablation of Persistent Atrial Fibrillation study
CI
confidence interval
CMAP
compound motor action potentials
CPAP
continuous positive airway pressure
CPVA
circumferential PV ablation
Cryo-FIRST
Catheter Cryoablation vs Antiarrhythmic Drug as First-Line Therapy of Paroxysmal AF trial
CS
coronary sinus
CSA
central sleep apnea
CT
computed tomography
CV
conduction velocity
DAD
delayed afterdepolarization
DE
delayed enhancement
DECAAF
Delayed Enhancement MRI and Atrial Fibrillation Catheter Ablation study
DF
dominant excitation frequency
DM
diabetes mellitus
DW-MRI
diffusion-weighted magnetic resonance imaging
EAM
electroanatomical mapping
EAST
Early Treatment of Atrial Fibrillation for Stroke Prevention Trial
EAVM
electroanatomical voltage mapping
ECG
electrocardiogram
ECGI
noninvasive electrocardiographic imaging
EF
ejection fraction
ERAF
early recurrence of AF
ERP
effective refractory period
FACM
fibrotic atrial cardiomyopathy
FAP
fractionated atrial potential
FAST
AF Catheter Ablation Versus Surgical Ablation Treatment trial
FDA
U.S. Food and Drug Administration
FIRM
focal impulse and rotor modulation
FLAIR
fluid-attenuated inversion recovery
FTI
force-time integral
GP
ganglionated plexi
HCM
hypertrophic cardiomyopathy
HDF
highest dominant excitation frequency
HF
heart failure
HFS
high-frequency stimulation
HR
hazard ratio
ICE
intracardiac echocardiography
IRGP
inferior right ganglionated plexi
ILR
implantable loop recorder
INR
international normalized ratio
LA
left atrial
LAA
left atrial appendage
LAD
left atrial dimension
LALA
left atrial linear ablation
LEGACY
Long-Term Effect of Goal Directed Weight Management on an Atrial Fibrillation Cohort study
LGE
late gadolinium-enhanced
LI
left inferior
LICU
low-intensity collimated ultrasound
LIPV
left inferior pulmonary vein
LOE
Level of Evidence
Look AHEAD
Action for Health in Diabetes
LS
left superior
LSPV
left superior pulmonary vein
LVEF
left ventricular ejection fraction
MANTRA-PAF
Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation
MAP
mean arterial pressure
MLWHF
Minnesota Living with Heart Failure questionnaire
MRI
magnetic resonance imaging
MVRR
mitral valve repair or replacement
NCDR
National Cardiovascular Data Registry
NCX
Na+-Ca2+ exchanger
NOAC
novel oral anticoagulant
NSAID
nonsteroidal anti-inflammatory drug
OAC
oral anticoagulation
OCEAN
Optimal Anticoagulation for Higher Risk Patients Post-Catheter Ablation for Atrial Fibrillation
ODIn-AF
Prevention of Silent Cerebral Thromboembolism by Oral Anticoagulation With Dabigatran After PVI for Atrial Fibrillation trial
OPC
objective performance criteria
OR
odds ratio
OSA
obstructive sleep apnea
PA
peripheral artery
PABA-CHF
Pulmonary Vein Antrum Isolation versus AV Node Ablation with Bi-Ventricular Pacing for Treatment of AF in Patients with Congestive Heart Failure
PAF
paroxysmal AF
PCC
prothrombin complex concentrates
PCWP
pulmonary capillary wedge pressure
PKA
protein kinase A
PN
phrenic nerve
PPIs
proton pump inhibitors
PROTECT AF
WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation
PS
phase singularity
PSD
peak skin dose
PV
pulmonary vein
PVAC
pulmonary vein ablation catheter
PVI
pulmonary vein isolation
QALY
quality-adjusted life year
QOL
quality of life
RA
right atrium
RAAFT
First Line Radiofrequency Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation Treatment
RAAFT-2
Radiofrequency Ablation versus Antiarrhythmic drugs as First-line Treatment of Paroxysmal AF
RCA
right coronary artery
RCT
randomized controlled trial
RD
risk difference
RE-CIRCUIT
Randomized Evaluation of Dabigatran Etexilate Compared to Warfarin in Pulmonary Vein Ablation: Assessment of an Uninterrupted Periprocedural Anticoagulation Strategy
RF
radiofrequency
RFA
radiofrequency energy ablation
RFC
radiofrequency catheter
RFCA
radiofrequency catheter ablation
RI
right inferior
RIPV
right inferior pulmonary vein
RP
refractory period
RR
relative risk
RS
right superior
RSPV
right superior pulmonary vein
RVSP
right ventricular systolic pressure
SARA
Study of Ablation Versus antiaRrhythmic Drugs in Persistent Atrial Fibrillation
SMART-AF
ThermoCool SmartTouch Catheter for the Treatment of Symptomatic Paroxysmal Atrial Fibrillation
SNP
single nucleotide polymorphism
SPECULATE
Effect of Amiodarone on the Procedure Outcome in Long-standing persistent AF Undergoing PV Antral Isolation
SR
sarcoplasmic reticulum
STAR AF II
Substrate and Trigger Ablation for Reduction of AF Trial Part II
STOP-AF
Sustained Treatment of Paroxysmal Atrial Fibrillation
SVC
superior vena cava
TEE
transesophageal echocardiogram
TIA
transient ischemic attack
VATS
video-assisted thoracoscopic surgery
VKA
vitamin K antagonist
WACA
wide-area circumferential ablation
WL
wavelength

Cited by (0)

Document Reviewers: Carina Blomström-Lundqvist, MD, PhD; Angelo A.V. De Paola, MD, PhD; Peter M. Kistler, MBBS, PhD; Gregory Y.H. Lip, MD; Nicholas S. Peters, MD; Cristiano F. Pisani, MD; Antonio Raviele, MD; Eduardo B. Saad, MD, PhD; Kazuhiro Satomi, MD, PhD; Martin K. Stiles, MB ChB, PhD; Stephan Willems, MD, PhD

Developed in partnership with and endorsed by the European Heart Rhythm Association (EHRA), the European Cardiac Arrhythmia Society (ECAS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Society of Cardiac Stimulation and Electrophysiology (Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología [SOLAECE]).

Developed in collaboration with and endorsed by the Society of Thoracic Surgeons (STS), the American College of Cardiology (ACC), the American Heart Association (AHA), the Canadian Heart Rhythm Society (CHRS), the Japanese Heart Rhythm Society (JHRS), and the Brazilian Society of Cardiac Arrhythmias (Sociedade Brasileira de Arritmias Cardíacas [SOBRAC]).

Chair: Hugh Calkins, MD, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Section Chairs:

Definitions, Mechanisms, and Rationale for AF Ablation: Shih-Ann Chen, MD, National Yang-Ming University, Taipei, Taiwan.

Modifiable Risk Factors for AF and Impact on Ablation: Jonathan M. Kalman, MBBS, PhD, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia.

Indications: Claudio Tondo, MD, PhD, Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Milan, Italy.

Strategies, Techniques, and Endpoints: Karl Heinz Kuck, MD, PhD, Asklepios Klinik St. Georg, Hamburg, Germany.

Technology and Tools: Andrea Natale, MD, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.

Technical Aspects of Ablation to Maximize Safety and Anticoagulation: David E. Haines, MD, Beaumont Health System, Royal Oak, MI, USA.

Follow-up Considerations: Francis E. Marchlinski, MD, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Outcomes and Efficacy: Matthew R. Reynolds, MD, MSc, Lahey Hospital and Medical Center, Burlington, MA, USA.

Complications: D. Wyn Davies, MD, Imperial College Healthcare NHS Trust, London, United Kingdom.

Training Requirements: Bruce D. Lindsay, MD, Cleveland Clinic, Cleveland, OH, USA.

Surgical and Hybrid AF Ablation: James R. Edgerton, MD, The Heart Hospital, Baylor Plano, Plano, TX, USA.

Clinical Trial Design: Atul Verma, MD, Southlake Regional Health Centre, University of Toronto, Toronto, Canada.

Correspondence: Heart Rhythm Society, 1325 G Street NW, Suite 400, Washington, DC 20005. E-mail address: [email protected].

Representative of the European Heart Rhythm Association (EHRA)

Representative of the American Heart Association (AHA)

Representative of the Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLAECE)

§

Representative of the Asia Pacific Heart Rhythm Society (APHRS)

Representative of the American College of Cardiology (ACC)

Representative of the European Cardiac Arrhythmia Society (ECAS)

#

Representative of the Society of Thoracic Surgeons (STS)

∗∗

Representative of the Canadian Heart Rhythm Society (CHRS)

††

Representative of the Japanese Heart Rhythm Society (JHRS)

‡‡

Representative of the Sociedade Brasileira de Arritmias Cardíacas (SOBRAC)