The Lead Episode 123: A Discussion of Re-Ablation of Atrial Fibrillation Targeting Electrogram Dispersion –The RESTART Trial, Live at HRX 2025-Speaker Information: A Discussion of Re-Ablation of Atrial Fibrillation Targeting Electrogram Dispersion

Speaker Information: A Discussion of Re-Ablation of Atrial Fibrillation Targeting Electrogram Dispersion – The RESTART Trial

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The RESTART Trial, discussed in a session hosted by Dr. Tina Baykaner (Stanford University), examines the efficacy of re-ablation procedures for atrial fibrillation (AF) that target electrogram dispersion. This investigation focuses on improving outcomes for patients undergoing repeat catheter ablation for recurrent AF by identifying areas of fragmented or dispersed electrograms, which may signify arrhythmogenic substrate suitable for ablation.<br /><br />The trial's authors include notable experts such as Dr. John D. Hummel, Dr. Haroon Rachid, Dr. Paul C. Zei, and others from prominent institutions. Contributors to the discussion included Dr. Paul C. Zei (Brigham and Women’s Hospital) and Dr. Jerome Kalifa (Volta Medical), both of whom disclosed affiliations with medical device companies and ongoing research engagements.<br /><br />Electrogram dispersion reflects complex atrial tissue abnormalities that standard pulmonary vein isolation may not fully address. By targeting these regions during re-ablation, the RESTART Trial evaluates whether this approach reduces arrhythmia recurrence better than conventional methods.<br /><br />The discussion highlights the potential for electrogram-targeted strategies to personalize AF management by identifying patient-specific pathological substrates, guiding more precise interventions during repeat procedures. The contributions from industry and academic experts, alongside disclosures, emphasize the collaborative effort to refine catheter ablation techniques.<br /><br />In summary, the RESTART Trial offers new insights into re-ablation of atrial fibrillation through targeting electrogram dispersion, aiming to improve success rates in patients with recurrent arrhythmia. The session provided a platform for expert dialogue on clinical implications, technical considerations, and future directions in AF ablation treatment.

Keywords

RESTART Trial

atrial fibrillation

re-ablation

electrogram dispersion

catheter ablation

arrhythmia recurrence

pulmonary vein isolation

arrhythmogenic substrate

personalized AF management

clinical outcomes