By Luis Aguinaga and Roberto Keegan
Europe and USA have produced most of the existent real-world data on catheter ablation of cardiac arrhythmias with single centre studies, surveys and national or international multicentre registries. Until now, data for catheter ablation of cardiac arrhythmias in a real-world setting in Latin America had been limited. The existent information had come from a few single centres and national multicentre registries carried out in some countries such as Argentina and Brazil. Therefore, the Latin American Society of Electrophysiology and Cardiac Stimulation (SOLAECE) undertook the first Catheter Ablation Registry including a good number of Latin American countries.
Information was collected retrospectively comprising all ablations performed in 2012. Participation was beyond our expectations, having received data from more than 120 centres in 13 countries-Argentina, Bolivia, Brazil, Chile, Colombia, Cuba, Dominican Republic, El Salvador, Guatemala, Mexico, Peru, Uruguay and Venezuela-which reported more than 15,000 ablation procedures.
Cardiac arrhythmias were divided into 17 substrates: atrioventricular node reentrant tachycardia, typical atrial flutter, atypical atrial flutter, left free wall accessory pathway, right free wall accessory pathway, septal accessory pathway, left focal atrial tachycardia, right focal atrial tachycardia, paroxysmal atrial fibrillation, non-paroxysmal atrial fibrillation, atrioventricular node, premature ventricular contractions, idiopathic ventricular tachycardia, post-myocardial infarction ventricular tachycardia, Chagas ventricular tachycardia, congenital ventricular tachycardia and ventricular tachycardia in other cardiopathies.
Some collected data were centre-related, such as population treated, hospital category, number of hospital beds, cardiac surgery availability, type of room where the ablations were performed (electrophysioloy lab, cath lab or operating room), weekly schedule of ablations, type and availability of fluoroscopy equipment, and use of electroanatomic mapping system, cryoablation and intracardiac echocardiography.
Other analysed data were type of catheter used (ie. 4mm, 8mm or irrigated tip), fluoroscopy equipment and type of anaesthesia (ie. local, conscious sedation or general).
Overall, the ablation success rate was 92% including all 17 substrates. This is relevant because in other registries-such as the latest Spanish registries-some arrhythmias such as atrial fibrillation and ventricular tachycardia in patients with structural heart disease have been excluded in the analysis of efficacy at the end of the ablation in the electrophysiology lab. The global complication rate was 4% and more than half of those were minor complications (haematoma). The mortality rate was quite low (0.05%) and similar to other registries.
In conclusion, to the best of our knowledge, this is the largest retrospective catheter ablation registry performed around the world. Despite some differences, these results seem to be similar to results reported in other countries showing that the procedure is safe and effective in Latin America.
Complete results of this registry will be published soon.
Luis Aguinaga is director Arrhytmia Unit, Centro Privado de Cardiologia, Tucuman, Argentina. He is president of SOLAECE and director of the Registry
Roberto Keegan is head of Electrophysiology, Hospital Privado del Sur, Bahia Blanca, Argentina. He is head of Guidelines and Registries of SOLAECE and coordinator of the Registry