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GAP-AF study helps to define optimal approach to ablation
Date:6/25/2013

Athens, Greece. Tuesday 25 June 2013: Using catheter ablation to create complete linear lesions around pulmonary veins, proved more effective than the creation of incomplete lesions in preventing recurrence of atrial fibrillation (AF), reports the GAP-AF study. The study, presented today in the Late Breaking Clinical Trials session I at the EHRA EUROPACE 2013 meeting in Athens, Greece, represents the first time that a randomized controlled study has been undertaken comparing the two different ablation strategies for patients with paroxysmal AF.

Identification of triggers initiating AF within the pulmonary veins led to prevention of AF recurrence by catheter ablation at the site of origin of the trigger. The Heart Rhythm Society /European Heart Rhythm Association/European Society of Cardiology Expert Consensus Document on Catheter and Surgical Ablation of Atrial Fibrillation (published in 2007 and updated in 2012) states that patients undergoing catheter ablation for AF should have complete isolation of the pulmonary veins, which involves a complete circumferential lesion being created around the pulmonary vein.

"This recommendation was based on observational studies, not on a prospective randomized trial. But some electrophysiologists (EPs) continue to believe that it's sufficient to create incomplete linear lesions where conduction sites still exist between the pulmonary veins and left atrium," explained Professor Karl Kuck, from Asklepios Klinik St George, Hamburg ,Germany, presenter of the GAP-AF study.

Part of their reasoning is that 95% of patients with AF recurrence after complete PV isolation procedures are found to have conduction gaps between the pulmonary veins and left atrium, he said. "Since they can't isolate the pulmonary veins permanently, they reason that incomplete isolation is sufficient and has the advantage of being a shorter procedure that has a potentially lower complication rate and costs less," said Prof Kuck.<
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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