Mortality risk one in 1000 for patients undergoing catheter ablation of AF
May 4, 2009 | 
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Milan, Italy - Roughly one patient in 1000 will die from complications caused by the catheter ablation of atrial fibrillation (AF), with the most common cause of death being tamponade, followed by stroke and atrioesophageal fistula [1].
These are the findings of a large retrospective analysis of 45 000 ablation procedures in 32 000 patients performed worldwide between 1995 and 2006. Investigators report that center experience did not appear to influence the risk of death, nor did different ablation techniques.
"The present study provides an unprecedented view of the causes and incidence of death in patients undergoing catheter ablation of AF, which may be of help in designing more appropriate and efficient [electrophysiology] EP settings for increasing current standards of procedural safety, planning start programs in EP centers with limited facilities or experience, delivering recommendations by regulatory authorities, and developing safer technologies," write Dr Riccardo Cappato (Policlinico San Donato, Milan, Italy) and colleagues in the May 12, 2009 issue of the Journal of the American College of Cardiology.
In an editorial accompanying the published report [2], Dr Bernard Belhassen (Tel-Aviv Sourasky Medical Center, Israel) asks whether a mortality rate of approximately one in 1000 can be considered an "acceptable risk" for patients with AF, particularly since the main expectation from the procedure is an improvement in the quality of life. Until recently, clinicians had little they could tell their patients about the procedure, except to say that it was associated with a relatively low complication rate, he notes.
These are the findings of a large retrospective analysis of 45 000 ablation procedures in 32 000 patients performed worldwide between 1995 and 2006. Investigators report that center experience did not appear to influence the risk of death, nor did different ablation techniques.
"The present study provides an unprecedented view of the causes and incidence of death in patients undergoing catheter ablation of AF, which may be of help in designing more appropriate and efficient [electrophysiology] EP settings for increasing current standards of procedural safety, planning start programs in EP centers with limited facilities or experience, delivering recommendations by regulatory authorities, and developing safer technologies," write Dr Riccardo Cappato (Policlinico San Donato, Milan, Italy) and colleagues in the May 12, 2009 issue of the Journal of the American College of Cardiology.
In an editorial accompanying the published report [2], Dr Bernard Belhassen (Tel-Aviv Sourasky Medical Center, Israel) asks whether a mortality rate of approximately one in 1000 can be considered an "acceptable risk" for patients with AF, particularly since the main expectation from the procedure is an improvement in the quality of life. Until recently, clinicians had little they could tell their patients about the procedure, except to say that it was associated with a relatively low complication rate, he notes.
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