Ablation strategies for atrial fibrillation

Joint Event on International Conference on Diabetes and Cholesterol Metabolism & 2^nd World Heart Rhythm Conference & 2^nd International Conference on Obesity and Diet Imbalance

November 25-26, 2019 | Dubai, UAE

Amr Alfakhouri

Lusatian Lakeland Klinikum GmbH, Germany

Keynote: J Hypertens

Abstract :

Atrial fibrillation (AF) is the most common sustained arrhythmia. Recent guidelines recommend pulmonary vein isolation (PVI) as the main procedural endpoint to control recurrent AF in symptomatic patients resistant to antiarrhythmic drugs. The efficacy of such a procedure is still unsatisfactory in persistent AF. Thus, the search is on-going in trying to find adjunctive strategies that can fortify the durability of ablation success in AF patients. This review summarizes the benefits of AF ablation techniques, discusses the evidence underlying different approaches other than PVI including: linear ablation, ablation of complex fractionated atrial electro grams (CFAE), focal impulse and rotor modulation (FIRM), ablation guided by spatiotemporal electro gram dispersion, repetitive activation patterns (RAPs) and other sites frequently involved in AF triggers. It is interesting that other independent randomized studies (for example SMAN-AF and STAR AF II trails) have failed to reproduce the same successful results. The reason for the lack of benefit associated with additional ablation in these trials is unclear. A possible explanation is that more extensive ablation may cause new, iatrogenic areas of arrhythmogenesis. It is noted that the low success rate occurred even though the rate of acute procedural AF termination during CFAE ablation was high.

Conclusion: Future studies need to focus on new ablation strategies to achieve better results.

Biography :

Amr Alfakhouri, after qualifying as an Internist in Syria in 2011, he continued with his residencies in Germany and then became a specialist in Internal Medicine and Cardiology in 2017. He has gained experience in the field of Cardiac Electrophysiology and Device Therapy at the Heart and Vascular Day Hospital Dresden (Praxisklinik Herz und Gefäße Dresden), the Heart Centre Dresden and Heart Centre Cottbus. Currently he is employed as a Consultant Interventional Cardiologist and Electrophysiologist at Lausitzer Seenland Klinikum in Hoyerswerda, Germany. He also participated in the global research “CABANA and RDN-AF Enlight” at the Heart Centre Dresden.