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

ponade) between the complete and incomplete groups.

"The study shows us for the first time that complete isolation of the pulmonary veins is more effective than incomplete isolation. It suggests that the level of evidence for complete ablation should be upgraded from class Ic to class Ia, where it is supported by a multicentre randomized trial," said Prof. Kuck.

However, the study also highlighted that recurrence rates were high even for patients who had undergone complete isolation procedures. "Research is urgently needed to improve ablation techniques to make the complete lines more durable. There is a need to explore other energy sources and tools for catheter ablation," he said.

The Fire and Ice trial, for example, is currently underway, to see whether a thermocool catheter might be more effect than cryo ablation for patients with paroxysmal AF.

The SARA study, also presented in the Late Breaking Clinical Trials session today, found that catheter ablation therapy was superior to medical therapy for maintenance of sinus rhythm in patients with persistent AF.

While a number of previous studies have showed the superiority of catheter ablation (CA) over antiarrhythmic drug therapy (ADT) for patients with paroxysmal AF, no previous studies have been undertaken specifically comparing ablation to drugs in patients with persistent AF. "Patients with persistent AF have in general been considered bad candidates for ablation, due to poor results, and the need for prolonged and aggressive procedures," explained principal investigator Professor Lluis Mont, from the Atrial Fibrillation Unit, University of Barcelona, Spain.

Between May 2009 and November 2011 in the open parallel Study of Ablation vs AntiaRrhythmic Drugs in Persistent Atrial Fibrillation (SARA) study Prof. Mont and colleagues, from eight ablation centres in Spain, randomly assigned a total of 146 patients with persistent AF 2:1 to CA (n=98) or ADT (n=48). AD
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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