New Expert Consensus Statement Presented on Catheter and Surgical Ablation of Afib

Today, the Heart Rhythm Society (HRS) in joint partnership with the European Heart Rhythm Association (EHRA), European Cardiac Arrhythmia Society (ECAS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLAECE) issued an international consensus statement that provides a state-of-the-art review of the indications, techniques, and outcomes of catheter and surgical ablation of atrial fibrillation (AF). The 2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation, first issued in 2007, and again in 2012, represents a state-of-the art review of the field of catheter and surgical ablation of AF. This document is a complete and comprehensive revision of the 2012 statement and was presented today at Heart Rhythm 2017, the Heart Rhythm Society’s 38th Annual Scientific Sessions.  
 
AF is a common arrhythmia condition that affects an estimated 33 million people worldwide and has been known to increase a person’s risk of stroke and death.¹ Catheter and surgical ablation of AF have evolved from investigational procedures to effective treatment options for patients. These procedures are now performed in most major hospitals throughout the world.
 
“The rate of advancement in the tools, techniques, and outcomes of AF ablation continues to increase at a rapid pace. Our writing group worked together to revise the current recommendations to address the medical advancements that have really evolved over the last five years,” said Hugh Calkins, M.D., FHRS, CCDS, past president of HRS, Nicholas J. Fortuin M.D. professor of Cardiology, and director of the Electrophysiology Laboratory and Arrhythmia Service at the Johns Hopkins Hospital. “It is our hope that this document can help improve patient care by providing a foundation for everyone involved in the care of AF patients including clinicians who perform catheter or surgical ablations.”
 
For the first time, the writing group, comprised of 60 experts from international organizations, addresses the important issue of catheter ablation of AF in select asymptomatic patients. The group also addresses the important issues of AF ablation as first-line therapy, the role of AF ablation in patients with heart failure, anticoagulation recommendations for patients undergoing ablation therapy, and the role of AF ablation in subgroups of patients not well represented in clinical trials. Recommendations pertinent to the design of clinical trials in the field of AF ablation and the reporting of outcomes, including relevant definitions, are also covered.
 
Definitions, Mechanisms, and Rationale for AF Ablation

• Modifiable Risk Factors for AF and Impact on Ablation
• Indications
• Strategies, Techniques, Endpoints
• Technology and Tools
• Technical Aspects of Ablation to Maximize Safety and Anticoagulation
• Follow-up Considerations
• Outcomes and Efficacy
• Complications
• Training Requirements
• Surgical and Hybrid AF Ablation· Clinical Trial Design

 
The expert consensus statement was written in collaboration with 11 organizations including the Heart Rhythm Society (HRS), European Heart Rhythm Association (EHRA), European Cardiac Arrhythmia Society (ECAS), Asia Pacific Heart Rhythm Society (APHRS), Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLAECE), Society of Thoracic Surgeons (STS), the American College of Cardiology (ACC), American Heart Association (AHA), Canadian Heart Rhythm Society (CHRS), Japanese Heart Rhythm Society (JHRS), and Sociedade Brasileira de Arritmias Cardíacas (SOBRAC).
 
The document was also published today in the online edition of Heart Rhythm, the official journal of the Heart Rhythm Society.
 
Heart Rhythm 2017 is the most comprehensive educational program for heart rhythm professionals, featuring more than 250 educational sessions and more than 130 exhibitors showcasing innovative products and services. The Heart Rhythm Society’s Annual Scientific Sessions have become the must-attend event of the year, allowing the exchange of new vital ideas and information among colleagues from every corner of the globe.
 
The Heart Rhythm Society is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education and optimal health care policies and standards. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 5,900 heart rhythm professionals in more than 70 countries around the world.
 
Reference:
1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation 129:837–847. Specifically, the document includes detailed findings within the following topic areas