[Very long term follow-up after radiofrequency ablation for atrial fibrillation: the Geneva experience]

Catheter ablation (CA) has emerged as an increasingly popular treatment option for selected patients with atrial fibrillation (AF) because drugs are frequently limited by side effects and poor effectiveness. However, very little data is available regarding outcomes of CA of AF beyond 5 years. Guidelines' recommendations are not clear regarding long-term oral anticoagulation (OAC) after 2 years. We assessed thromboembolic events (TE) and AF ablation outcomes at very long-term follow-up (> 5 years) after CA. During a mean follow-up of 9 years after CA, 68% patients were in stable sinus rhythm without anti-arrhythmic drugs and the TE event rate was 0.41 per 100 patients/year. Our data suggests that patients post ablation with a high risk for stroke (CHA2DS2-VASc ≥ 2) should however continue OAC treatment.