Update On Ablation Strategies For Persistent AF (non-ACE)-Update On Ablation Strategies For Persistent AF (non-ACE)

Video Transcription

Video Summary

The session, chaired by Dr. Karim Ben Ali and Dr. Richard Schilling, focused on updates in ablation strategies for atrial fibrillation (AF). Key presentations included Dr. Jonathan Coleman's discussion on catheter ablation, highlighting consensus from 2024 largely recommending pulmonary vein isolation (PVI) for persistent AF and acknowledging areas of uncertainty beyond that. Dr. Pierre Gé presented the "Marshall Plan," which includes Vein of Marshall ethanol infusion in ablation strategies, and he contextualized its historical relevance and current clinical application.<br /><br />Dr. Peter Kessler critiqued posterior wall isolation's role, referencing the CAPLA study, which found no advantage from isolating the posterior wall using either radiofrequency (RF) or pulse field ablation (PFA). He noted specific patient subsets might benefit from additional procedures. Dr. Elaine Wan rounded off with insights on AI-guided strategies, rooted in spatial temporal electrogram dispersion, as shown by the tailored AF trial, revealing potential but acknowledging challenges in enhancing procedure time and reducing atrial arrhythmias.<br /><br />The discussion highlighted key challenges, including tailoring ablation to patient-specific electrophysiological profiles, balancing comprehensive strategy inclusion (like PFA) with procedural efficiency, and leveraging AI for predicting patient outcomes and customizing treatments. Overall, the session underscored advancements in technology and methodology alongside the lingering need for precision and personalized treatment in AF management.

Keywords

ablation strategies

atrial fibrillation

pulmonary vein isolation

Vein of Marshall

posterior wall isolation

radiofrequency ablation

pulse field ablation

AI-guided strategies

electrophysiological profiles

personalized treatment