EuroPace 2013 wrap up — A major study on AF ablation and the limits of gene testing in Cardiology

I’m writing this from home. The travel back was uneventful and I actually got a little caught up in the office Friday. It was a fun trip but getting back to doctoring felt good. Atrial Fibrillation ablation: The Gap-AF trial was released as the lead late-breaker at EuroPace 2013. There were many remarkable (‘they-really-did-that’ sort of) features of this study. Born from a (Italian/German) debate on whether complete isolation of the pulmonary veins is needed, Gap-AF investigators swallowed hard and randomized German patients to two groups. The complete isolation group underwent AF ablation done in the currently accepted way–complete isolation of the PVs. The incomplete isolation group had the same procedure, only right before complete isolation occurred, investigators left a single gap. That must have been hard to do, because in their hearts, these German investigators believe leaving gaps is nuts. But it had never been studied, and in science, evidence trumps beliefs. The second amazing thing about Gap-AF was that the researchers took every patient back to the lab to look at the status of their veins. That’s shocking because it meant exposing patients to the risk of a second procedure whether they were symptomatic or not. This would not past muster in most ethics review boards. But you learn a lot from re-studying every patient. Gap-AF added significant knowledge to the world of AF ablation. Here’s my post on theHeart.org. Genetic Testing: The next penicill...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs