UMEAA, SWEDEN. Being a highly organized country it should come as no surprise that Sweden actually has a National Catheter Ablation Registry that records the outcome of every single catheter ablation performed in this country of 9.2 million people. In 2007 a total of 2,314 ablations were carried out in 8 specialized centers. Of these, 521 procedures were for atrial fibrillation (AF) and 414 for atrial flutter (AFL). This translates to 57 AF procedures per million inhabitants. Considering that about 90,000 newbies join the ranks of afibbers every year in Sweden (incidence about 1%) and that the total number of afibbers in Sweden is likely close to 500,00 (based on European prevalence of 5.5%), it is clear that only a very small proportion of patients (around one in a thousand) presently receive curative treatment for AF in Sweden. It certainly would be of interest to see comparative numbers for the US, Canada, and the UK, but unfortunately none of these countries have national catheter ablation registries.
The most common procedure (accounting for 25% of overall volume) carried out in 2007 was for supraventricular tachycardia (SVT). Atrial fibrillation ablation accounted for 23% of overall volume and atrial flutter for 18%. Mean procedure time for an AF ablation was about 3.5 hours with an average fluoroscopy exposure of 43 minutes. The most common procedural complication was hemorrhage (requiring treatment) at 1.7% followed by pericardial effusion at 0.4%. Tamponade, valve damage, pulmonary embolus, cerebral embolus, and pseudoaneurysm each accounted for about 0.2% bringing the total complication rate to 2.9%. In contrast, the complication rates for SVT and AFL procedures were 1.8% and 0.7% respectively. The acute success rate for an AF procedure was 89%, but unfortunately, no data are presented for long-term success.
Kesek, M. Ablation procedures in Sweden during 2007: results from the Swedish Catheter Ablation Registry. Europace, Vol. 11, 2009, pp. 152-54