Radiofrequency-Based Ablation Demonstrates Excellent Outcomes in Patients With Atrial Fibrillation

Radiofrequency (RF)-based ablation is highly effective for patients with atrial fibrillation (AF), according to a study recently presented at Heart Rhythm 2024.

RF-based ablation, which uses radiofrequency energy to inactivate the heart tissue responsible for producing irregular electrical signals, has demonstrated robust safety in randomized, controlled clinical trials. However, the technique is still evolving, and little is known about its efficacy and safety outside of clinical trials.

In this study, researchers used data from the REAL-AF registry to assess 2470 patients who had undergone RF-based ablation for paroxysmal AF. At 1 year of follow-up, freedom from all-atrial arrhythmia and AF were 81.6 % and 85.7%, respectively. Moreover, 93.2% of patients reported no arrhythmia symptoms during the follow-up period. Average procedure time was also significantly shorter, which improves patient safety by reducing time under anesthesia and means that hospitals and operators can perform more of these high-demand procedures.

“When we incorporate what we think are the best strategies for RF-based ablation, we can further improve the long-term patient outcomes,” said corresponding author Paul Zei, MD, an electrophysiologist and physician-researcher at Brigham and Women’s Hospital, via a press release. “With high-volume experienced operators using these best practices, we are reporting excellent short- and long-term clinical outcomes, with more than 80% long-term success and very low complication rates.”

Moving forward, Dr. Zei and colleagues hope to refine the RF-ablation procedure for not only paroxysmal AF, but also persistent AF. “It’s an ongoing endeavor,” said Dr. Zei. “An important next step will be to apply similar strategies to try to understand how this procedure can be improved for patients with the persistent type of AF, which is more difficult to treat than paroxysmal AF.”

Dr. Zei added that this registry model can seamlessly adapt to optimize other medical procedures. “As well as being a study, the registry is a learning health network. We’re not only evaluating the best approach for RF-based ablation; we’re also learning from each other. The goal is to disseminate best practices across every operator and center.”