Doctors & patients are saying about 'A-Fib.com'...
"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."
Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN
"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."
Jill and Steve Douglas, East Troy, WI
“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP.
Faye Spencer, Boise, ID, April 2017
“I think your site has helped a lot of patients.”Dr. Hugh G. Calkins, MD Johns Hopkins,
Baltimore, MD
2024 AF Symposium
The Benefits of Ablation Across the AF Spectrum: From Early Intervention to Late-Stage Heart Failure: Part V
This important Friday session had five speakers: Dr. Stephen Willems, Dr. Jason Andrade, Dr. Philipp Sommer, Dr. Douglas Packer and Dr. Francis Marchlinski.
Dr. Francis Marchlinski
Dr. Francis Marchlinski of the Un. of Pennsylvania, Philadelphia, PA, gave the 5th talk in what was described as the “most important session of the whole meeting.”
Medications vs Catheter Ablation for Initial Treatment of AF–Guidance for the Clinician
Dr. Marchlinski cited several recent studies (such as “STOP-AF“) which have led researchers to change today’s AF Guidelines. Catheter Ablation is now a first-choice option (Class 1A) for most patients. [See Excerpts from the AF Guidelines below].
Current research and today’s guidelines suggest a lower threshold for using catheter ablation both because of increased efficacy and decreased AF progression.
Medical Therapy Still Needed
Dr. Marchlinski made a point of stating that medical therapy (use of antiarrhythmic drugs) was not going away. Even though catheter ablation is low risk, it’s not risk free. Some patients are risk adverse or have other reasons for avoiding ablation. If patients are on medications [while avoiding amiodarone], they should be monitored for recurrence.
But patient preferences are an important part of the decision making. It’s important for doctors and patients to have this discussion.
To read other presentations in this series, go to My Summary Reports Written for Atrial Fibrillation Patients.
Editor’s Comments
Editor’s CommentsDr. Marchlinski’s presentation showed how current research and management Guidelines have progressed to state that catheter ablation is acknowledged as superior to medical therapy and is now a first-choice option for most A-Fib patients.
He notes that drug therapy isn’t going away and remains an important option for A-Fib patients.
What Guidelines are we referring to? Your cardiologist and electrophysiologist are guided by the following:
• 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
I’ve listed pertinent excerpts from the AF Guidelines:
Section: 8.4. AF Catheter Ablation
Catheter ablation is more effective “in patients with symptomatic AF in whom antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred.”
“In selected patients with symptomatic paroxysmal AF …catheter ablation is useful as first-line therapy to improve symptoms and reduce progression to persistent AF.”
“In patients with…AFL (Flutter), catheter ablation is useful for improving symptoms.”
Synopsis (excerpt):
“Ablation for AF is more effective than antiarrhythmic drugs for both persistent and paroxysmal AF and that earlier implementation of rhythm control strategies is an important factor for improving AF ablation success rates.”
Return to 2024 AF Symposium Reports
If you find any errors on this page, email us. Y
Last updated: Thursday, July 18, 2024
