Spanish catheter ablation registry. 23rd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2023)

We report the results of the 2023 Spanish catheter ablation registry. Procedural data were collected and incorporated into the REDCap platform by all participating centers through a specific form. There were 104 participating centers in 2023 compared with 103 in 2022. In 2023, the total number of ablation procedures was 26 207, indicating a stabilization of the increase observed in 2022 following the pandemic. The increase was mainly due to procedures for atrial fibrillation (AF), with a total of 9942 ablations, representing 38% of all substrates. Notably, pulse-field ablation represented 10.3% of all AF ablation procedures, leading single-shot ablation strategies to outnumber point-by-point AF ablation for the first time in the history of the registry. Cavotricuspid isthmus ablation remained the second most targeted substrate (19% of all substrates, n=5067). The overall acute success rate remained high (97%), with a downward trend in the complication rate (1.6% vs 1.8% in 2022) and mortality rate (0.03%; n=7). Compared with 2022, there was a significant increase in procedures performed using electro-anatomical mapping and zero-fluoroscopy techniques for cavotricuspid isthmus ablation (52% vs 26%), AV node re-entrant tachycardia (48% vs 34%), and accessory pathways (62% vs 22%). We registered 466 ablations in pediatric patients. The data indicate a stabilization in the post-pandemic increase in ablation procedures, with an absolute and relative increase in AF as the predominant substrate. Success rates remained stable with a modest reduction in complication and mortality rates. Se presentan los resultados del Registro español de ablación con catéter correspondientes al año 2023. Registro retrospectivo de las ablaciones realizadas en los hospitales nacionales participantes incorporadas en la plataforma REDCap mediante formulario específico. Participaron 104 centros, respecto a los 103 participantes en 2022. En 2023 se ha estabilizado el incremento de ablaciones (n=26.207) respecto al notable aumento de la actividad en 2022 tras la pandemia. El incremento de casos ha sido fundamentalmente a expensas del sustrato predominante, la fibrilación auricular (FA) (n=9.942), que representa el 38% del total de sustratos. Destaca la irrupción de la electroporación (el 10,3% del total de ablaciones de FA), a expensas de lo cual el número de procedimientos de crioablación ha superado por primera vez al de punto a punto. En segundo lugar, se mantiene la ablación de istmo