Our Summary

This research study compared two procedures used to treat long-standing persistent atrial fibrillation (LSPAF), a heart condition where the heart beats irregularly for a long period of time. The two procedures are known as hybrid-convergent radiofrequency (RF) ablation and pulsed field ablation (PFA).

The research involved 93 patients with LSPAF who were either treated with the hybrid-convergent RF ablation (49 patients) or PFA (44 patients). The goal was to determine which treatment was more effective at preventing the return of irregular heart beats after a three-month period, and safer in terms of side effects and complications.

The study found that both procedures were successful and there was no significant difference in the return of irregular heart beats between the two groups after 12 months. However, patients who had a larger left atrial volume and recurrences during the blanking-period were more likely to experience a return of irregular heart beats, regardless of the procedure used.

Despite similar effectiveness, the study found that PFA had a better safety profile. It had fewer major complications during the procedure compared to the hybrid-convergent RF ablation. Thus, the study concludes that while both procedures have similar outcomes in treating LSPAF, the hybrid-convergent RF ablation carries higher risks during the procedure.

FAQs

  1. What are the two procedures compared in this research study for treating long-standing persistent atrial fibrillation (LSPAF)?
  2. What factors were found to increase the likelihood of a return of irregular heart beats after either procedure?
  3. Which procedure was found to have a better safety profile and fewer complications during the procedure?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about cardiac ablation is to discuss with their healthcare provider the potential risks and benefits of different ablation procedures, such as hybrid-convergent RF ablation and PFA, in order to make an informed decision about their treatment plan. It is important to consider factors such as individual health conditions, left atrial volume, and previous recurrences of irregular heart beats when determining the most suitable procedure for the patient. Regular follow-up appointments with the healthcare provider are also essential to monitor the effectiveness of the procedure and address any concerns or complications that may arise.

Suitable For

Patients with long-standing persistent atrial fibrillation (LSPAF) who have not responded well to other forms of treatment such as medication or catheter ablation may be recommended for cardiac ablation. In particular, patients with a larger left atrial volume and a history of recurrences during the blanking period may benefit from cardiac ablation to prevent the return of irregular heart beats. Additionally, patients who are deemed to be at high risk for complications during the procedure may be recommended for a less invasive option such as pulsed field ablation (PFA) over more traditional methods like hybrid-convergent radiofrequency (RF) ablation.

Timeline

In summary, before the cardiac ablation procedure, the patient may have experienced symptoms of LSPAF such as irregular heart beats, fatigue, dizziness, and shortness of breath. They would have undergone various tests and consultations with their healthcare provider to determine the best course of treatment.

During the cardiac ablation procedure, the patient would have been sedated and the surgeon would have used either RF ablation or PFA to target and destroy the areas of the heart causing the irregular heart beats.

After the procedure, the patient would have been monitored closely for any complications or side effects. They may have experienced some discomfort or soreness at the site of the catheter insertion. They would have also been prescribed medication to prevent the return of irregular heart beats.

In the following weeks and months, the patient would have continued to follow up with their healthcare provider for monitoring and adjustments to their treatment plan. They would have been advised to make lifestyle changes such as quitting smoking, eating a healthy diet, and exercising regularly to improve their overall heart health.

Overall, the patient’s experience before and after cardiac ablation would involve a combination of medical assessments, procedures, monitoring, and lifestyle changes to manage their condition and improve their quality of life.

What to Ask Your Doctor

  1. What is the success rate of cardiac ablation in treating my specific condition (LSPAF)?
  2. What are the potential risks and complications associated with hybrid-convergent RF ablation and PFA?
  3. How experienced are you in performing each of these procedures?
  4. How long is the recovery time for each procedure?
  5. Will I need to take any medications after the procedure? If so, what are the potential side effects?
  6. How often will I need follow-up appointments after the procedure?
  7. Are there any lifestyle changes or restrictions I need to be aware of post-procedure?
  8. How will you determine which procedure is the best option for me?
  9. Are there any alternative treatments to cardiac ablation that I should consider?
  10. What is the long-term prognosis for LSPAF after undergoing either hybrid-convergent RF ablation or PFA?

Reference

Authors: Bianchini L, Schiavone M, Vettor G, Gasperetti A, Penza E, Ballotta A, Pirola S, Brambillasca C, Zito E, De Lio F, Ventrella N, Tundo F, Moltrasio M, Fassini G, Polvani G, Tondo C. Journal: JACC Clin Electrophysiol. 2024 Jul;10(7 Pt 2):1700-1710. doi: 10.1016/j.jacep.2024.05.029. PMID: 39084744