Big news in AF ablation from HRS 2016

I have recently returned from the 2016 Heart Rhythm Society Sessions in San Francisco. I wrote three articles for Medscape. I also did two podcasts from HRS. I will link these below. You need to sign up for Medscape (free) to read the essays and listen to the podcast. In the first article, I discussed the good and bad of AF ablation. The good being the increase in quality of life seen in about two-thirds of patients who have ablation. The bad being a study from a Japanese registry which found 1 in 3 patients sustained post-procedural “sub-clinical cerebral ischemic” lesions on brain MRI scans. To translate, that means the researchers found small areas of damage in the brain–likely from debris going north from the heart to the brain during the procedure. Finding post-procedural ‘white spots’ are not new. What’s new about this study was the very high frequency. There are critics and downplayers of these concerns. They say…no worries, if you give enough anticoagulant drugs and manage the sheaths properly, you can avoid the problem. The non-worriers also make the point that these lesions go away over time. Maybe so. But the Japanese study I cited was larger than previous trials–and they did the procedure in the normal way. The title of the article is The Parallax of AF Ablation on Display at HRS. History may prove me wrong, but I think being more selective in choosing patients for AF ablation will look wise. The second article I wro...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs