Catheter ablation for atrial fibrillation-Update focused on the Czech Republic

Today, catheter ablation has become a routine part of rhythm control in patients with atrial fibrillation (AF). In the Czech Republic (C.R.), these procedures are recorded in a nationwide registry, which is managed online and gives an overview on procedure rates and development trends. Palliative procedures, i.e. AV node ablation, are infrequently used nowadays and their rate did not change significantly within last 15 years. Contrary to that, the rate of selective ablation procedures of AF is steeply rising. In the C.R., these procedures are carried out in 10 centers, and 1590 ablation procedures of AF were carried out in the year 2011. With its ablation rate per million inhabitants the C.R. ranks among the highest in Europe. For ablation, radiofrequency energy is used most frequently (93%), followed by cryoenergy (5% procedures), and laser energy (2% procedures). Of the 3-dimensional electroanatomic mapping methods the system Carto (66% ablations) and NAV x-system (22% ablations) are used most frequently. Real-time imaging using intracardiac echocardiography is widely used (73% ablation), which results in enhanced safety of the procedures. Mortality associated with AF ablation is 0.04% (3 cases out of the total of 7300 ablation procedures in the registry).