National heart foundation of Australia consensus statement on catheter ablation as a therapy for atrial fibrillation

Jonathan M. Kalman, Prashanthan Sanders, David B. Brieger, Anu Aggarwal, Nick A. Zwar, James Tatoulis, Andre E. Tay, Alison Wilson, Maree G. Branagan

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Abstract

Atrial fibrillation (AF) is estimated to affect 1%-2% of the population. It is increasing in prevalence and is associated with excess mortality, considerable morbidity and hospitalisations. AF is responsible for a significant and growing societal financial burden. • Catheter ablation is an increasingly used therapeutic strategy for the management of AF; however, some confusion exists among those caring for patients with this condition about the role and optimal use of ablative treatments for AF. • Our aim in this consensus statement is to provide recommendations on the use of primary catheter ablation for AF in Australia, on the basis of current evidence. • Our consensus is that the primary indication for catheter ablation of AF is the presence of symptomatic AF that is refractory or intolerant to at least one Class 1 or Class 3 antiarrhythmic medication. • In selecting patients for catheter ablation of AF, consideration should be given to the patient's age, duration of AF, left atrial size and the presence of significant structural heart disease. Best results are obtained in younger patients with paroxysmal AF, no structural heart disease and smaller atria. • Ablation techniques for patients with persistent AF are still undergoing evaluation. • Discontinuation of warfarin or equivalent therapies is not considered a sole indication for this procedure. • After AF ablation, anticoagulation therapy is generally recommended for all patients for at least 1-3 months. Discontinuation of warfarin or equivalent therapies after ablation is generally not recommended in patients who have a CHADS2 score (congestive heart failure, hypertension, age ≥75 years, diabetes, 1 point each; prior stroke or transient ischaemic attack, 2 points) of ≥2.

Original languageEnglish
Pages (from-to)518-521
Number of pages4
JournalMedical Journal of Australia
Volume198
Issue number1
DOIs
Publication statusPublished - 1 Jan 2013
Externally publishedYes

Fingerprint

Catheter Ablation
Atrial Fibrillation
Consensus
Therapeutics
Warfarin
Heart Diseases
Ablation Techniques
Transient Ischemic Attack
Type 1 Diabetes Mellitus
Hospitalization
Heart Failure
Stroke

Cite this

Kalman, Jonathan M. ; Sanders, Prashanthan ; Brieger, David B. ; Aggarwal, Anu ; Zwar, Nick A. ; Tatoulis, James ; Tay, Andre E. ; Wilson, Alison ; Branagan, Maree G. / National heart foundation of Australia consensus statement on catheter ablation as a therapy for atrial fibrillation. In: Medical Journal of Australia. 2013 ; Vol. 198, No. 1. pp. 518-521.
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Kalman, JM, Sanders, P, Brieger, DB, Aggarwal, A, Zwar, NA, Tatoulis, J, Tay, AE, Wilson, A & Branagan, MG 2013, 'National heart foundation of Australia consensus statement on catheter ablation as a therapy for atrial fibrillation' Medical Journal of Australia, vol. 198, no. 1, pp. 518-521. https://doi.org/10.5694/mja12.10929

National heart foundation of Australia consensus statement on catheter ablation as a therapy for atrial fibrillation. / Kalman, Jonathan M.; Sanders, Prashanthan; Brieger, David B.; Aggarwal, Anu; Zwar, Nick A.; Tatoulis, James; Tay, Andre E.; Wilson, Alison; Branagan, Maree G.

In: Medical Journal of Australia, Vol. 198, No. 1, 01.01.2013, p. 518-521.

Research output: Contribution to journalArticleResearchpeer-review

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