The concept of CHERRY PICKING
Choosing the optimal candidates for AF ablation is the same concept as picking the ripen cherry.
1. New AF
Early Ablation reduces AF recurrence
Early Ablation reduces AF progression
Who are & are NOT
'EARLY AFers'?
1. Early Ablation (ie. within 1yr since diagnosis) reduces AF recurrence and AF progression.
2. Optimal candidates: young, paroxysmal AF, normal LA size and LVEF, and without significant structural heart disease.
2. Very Symptomatic AF
In both paroxysmal and persistent AF, catheter Ablation reduces symptoms and improves quality of life.
3. HFrEF
In CASTLE-AF,
ablation reduces mortality in SELECTED HFrEF patients.
AF ablation improve cardiovascular outcomes in selected HFrEF patients.
4. HFpEF
Data is less robust than data in HFrEF.
In AF with HFpEF, catheter ablation may be considered to
improve cardiovascular outcomes esp. in those whom AF was diagnosed within 1yr.
Too Early or Too (little too) Late
Too early to ablate these AFs,
but it is still required long-term monitoring.
Some patients may not receive the benefits of AF ablations as much as others.
1. It would be too early to ablate AF due to reversible cause(s). However, long-term monitoring for further AF episodes is recommended.
2. Younger patients with less structural heart diseases are likely to receive benefits from ablation.
3. Hospital procedural volumes are associated with outcomes after ablation.
AF Ablation Class Recommendation
Heart Rhythm Box is a collection of web-paged style presentations in clinical cardiac electrophysiology topics.
The page is created mainly for educational purpose.
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