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Stroke and systemic embolism following atrial fibrillation ablation: the EMBOL-AF Global Registry
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European Heart Journal | March 31, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Background and Aims Stroke and systemic embolism are recognized but poorly characterized complications of atrial fibrillation (AF) and left atrial flutter (AFL) catheter ablation. Their incidence, outcomes, and procedural associations remain insufficiently defined. Methods Retrospective global registry was initiated by the European Heart Rhythm Association Scientific Committee. A secure database captured data from ablation centres worldwide on general AF and left AFL ablation activity, as well as detailed information on patients with symptomatic embolic events between 2017 and 2024. Results Overall, 204 centres reported 335 743 ablation procedures and 550 embolic events (incidence 0.16%). Centre-level rate ranged from 0% to 3.1%. Most events were cerebral (94%), followed by peripheral (5%), and combined (1%). Coronary air embolism accounted for 62% of all peripheral events. Intraprocedural events occurred in 93 patients (17%), within 72 h in 357 (78%) and beyond 72 h in 100 (22%); 128 cases (23%) were diagnosed after hospital discharge. Nonparoxysmal AF (0.23% vs 0.15%; P < .001), centre experience, and ablation energy source (radiofrequency, 0.16%; cryoballoon, 0.16%; pulsed field ablation, 0.25%; laserballoon, 0.88%; P < .001) were associated with embolic risk. Median NIHSS score after stroke was 4 (interquartile range, 2–9). Three-month follow-up was available for 518 patients with embolism (95%): 181 (35%) had sequelae and 16 (3%) died. Conclusions Symptomatic embolic events are infrequent but associated with significant morbidity and mortality. Most events occur early, though a substantial proportion arise later. Higher event rates were observed with laser and possibly with pulsed field ablation. A greater centre experience was associated with a lower embolism incidence.
EHRA consensus on prevention and management of interference due to medical procedures in patients with cardiac implantable electronic devices
Stühlinger, Markus , Burri, Haran , Vernooy, Kevin , Lenarczyk, Radosław , Brunner, Michael, Ramos, Jorge Toquero , Stolfo, Giuseppe Di , Suleiman, Mahmoud, Tinhofer, Florian, Cakulev, Ivan , Yeo, Wee Tiong, Lau, Dennis H. , Mulpuru, Silva K, Nielsen, Jens Cosedis , Group:, ESC Scientific Document, Prabhu, Mukundaprabhu, Rinaldi, Christopher A. , Sacher, Frédéric, Guillen, Raul Horacio, Pooter, Jan De , Prenner, Günther, Fichtner, Stephanie , Nitta, Takashi , Nielsen, Jens C , Brunner, Michael , Burri, Haran , Garcia, Rodrigue , Sultan, Arian , Sabbag, Avi , Özcan, Emin Evren , Suleiman, Mahmoud , Aristizábal, Julián M. , Eidelman, Gabriel, Group:, ESC Scientific Document, Heinzel, Frank R. , Gandjbakhch, Estelle , Sheldon, Seth H. , Mason, Pamela Kay
Europace | October 7, 2022 | Volume: 24 | Issue: 9 | Pages: 1512-1537
Quality indicators for the care and outcomes of adults with atrial fibrillation
Arbelo, Elena , (Chair), Drossart, Inga , Dwight, Jeremy, Hills, Mellanie True , Hindricks, Gerhard , Lane, Deirdre A. , Lau, Dennis H. , Lettino, Maddalena , Lobban, Trudie , Pak, Hui‐Nam , Potpara, Tatjana , Sáenz, Luis Carlos , Gelder, Isabelle C. Van , Varosy, Paul D. , Gale, Chris P , Dagres, Nikolaos , (Co-chair), Reviewers, coordinator), (review, Defaye, Pascal , Lenarczyk, Radosław , Providência, Rui , Palmero, María José Guerra , Takahashi, Yoshihide , Sarkozy, Andrea , Glotzer, Taya V. , Kusumoto, Fred M, Dagres, Nikolaos , Providencia, Rui , Arbelo, Elena , Lane, Deirdre A , (Chair), Aktaa, Suleman , Bollmann, Andreas , d'Avila, Andre , Kusumoto, Fred , Lip, Gregory Y H , (Co-chair), Reviewers, Bovéda, Serge , coordinator), (review, Deneke, Thomas , Conte, Giulio , Pisani, Cristiano , Nava, Santiago , Oliveira, Mário
EP Europace | August 31, 2020 | Volume: 23 | Issue: 4 | Pages: 494-495
Abstract Aims To develop quality indicators (QIs) that may be used to evaluate the quality of care and outcomes for adults with atrial fibrillation (AF). Methods and results We followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of AF care for the diagnosis and management of AF (by a group of experts including members of the ESC Clinical Practice Guidelines Task Force for AF); (ii) the construction of candidate QIs (including a systematic review of the literature); and (iii) the selection of the final set of QIs (using a modified Delphi method). Six domains of care for the diagnosis and management of AF were identified: (i) Patient assessment (baseline and follow-up), (ii) Anticoagulation therapy, (iii) Rate control strategy, (iv) Rhythm control strategy, (v) Risk factor management, and (vi) Outcomes measures, including patient-reported outcome measures (PROMs). In total, 17 main and 17 secondary QIs, which covered all six domains of care for the diagnosis and management of AF, were selected. The outcome domain included measures on the consequences and treatment of AF, as well as PROMs. Conclusion This document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes), and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care.