Catheter and surgical ablation guidelines for atrial fibrillation unveiled

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Heart organizations released the first international clinical consensus statement on using catheter and surgical ablation techniques to treat atrial fibrillation (AF) at Heart Rhythm 2007, the Heart Rhythm Society's 28th Annual Scientific Sessions.

The Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation aims to improve patient care by providing physicians with a state-of-the-art review of catheter and surgical ablation for AF, the most common heart rhythm disorder and a rapidly growing health problem for more than three million Americans. Studies have found that only one quarter of patients with AF receive appropriate care.

Convened by HRS, international heart rhythm specialists representing the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the European Cardiac Arrhythmia Society (ECAS), the Society of Thoracic Surgeons (STS) and HRS has developed guidelines to provide a foundation of current knowledge for medical personnel involved with catheter and surgical ablation of AF. The statement addresses the indications, techniques, training, and follow-up for patients undergoing these procedures.

According to the Expert Consensus Statement, ablation for AF should be considered in AF patients whose symptoms are severe enough to interfere with their quality of life and have failed or been intolerant to treatment with at least one antiarrhythmic medication. Ablation of AF is more difficult, associated with greater risks, and requires more careful follow-up than other ablation procedures. Therefore, the statement stresses that training for ablation of AF should encompass six fundamental principles:

  • Appropriate selection of patients;
  • Knowledge of the anatomy of the atria and adjacent structures;
  • Conceptual knowledge of strategies to ablate AF;
  • Technical competence;
  • Recognition, prevention, and management complications; and
  • Appropriate follow-up and long-term management.