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HRS updated consensus statement on catheter surgical ablation of AF
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The Heart Rhythm Society released an updated international consensus statement on indications, techniques and outcomes of catheter and surgical ablation of atrial fibrillation.
The expert consensus statement is an update to the first AF consensus statement released in 2007.
“As we continue to learn more about the treatment of AF, it is important to update our resources accordingly, and in this case, our document is intended to improve patient care by providing the most current foundation of knowledge for those involved in catheter and surgical ablation of AF,” Hugh Calkins, MD, FHRS, CCDS, first vice president of the Heart Rhythm Society and director of cardiac arrhythmia services and the electrophysiology laboratory at The Johns Hopkins Hospital, said in a press release.
Hugh Calkins
The updated statement focuses on the most recent advancements in the field of catheter and surgical ablation. The statement includes recommendations for 11 topic areas, including:
- AF definitions, mechanisms and rationale for ablation.
- Indications for catheter and surgical ablation of AF.
- Techniques and endpoints for AF ablation.
- Technologies and tools.
- Other technical aspects; anticoagulation, anesthesia and esophageal monitoring.
- Follow-up considerations.
- Outcomes and efficacy of AF ablation.
- Complications.
- Training requirements and competencies.
- Surgical ablation of AF.
- Clinical trial considerations and definitions.
Specifically, notable updates were added in the areas of indications and techniques. These updates include the addition of class and level grades of indications for catheter and surgical ablation of AF when performed by an electrophysiologist who has received the proper training or has a certain level of experience. The experts also compiled specific recommendations for the management of anticoagulation strategies before, during and after ablation, including information on newer anticoagulants. The update also includes a list of 53 definitions intended to guide clinical research. Definitions focus on reporting outcomes of AF ablation, clinical trials of catheter or surgical ablation of AF and associated complications.
The Heart Rhythm Society convened a panel of 45 experts representing seven national organizations to update the statement. The statement was written in joint partnership with the European Heart Rhythm Association, European Cardiac Arrhythmia Society, American College of Cardiology, American Heart Association, Asia Pacific Heart Rhythm Society and The Society of Thoracic Surgeons.
Bruce Wilkoff
“This statement, along with other consensus statements issued on an annual basis, is intended to provide a uniformed standard of care with the goal of improving the overall safety and efficacy of patient care around the world,” Bruce L. Wilkoff, MD, FHRS, president of the Heart Rhythm Society and a member of the Cardiology Today Editorial Board, said in the press release.
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Disclosure: Dr. Calkins is a consultant or on the advisory board for Atricure, Biosense Webster, Medtronic, Sanofi-Aventis and Toray Medical, and he is a partner at iRhythm. He also received research grants from Boston Scientific, Medtronic and St. Jude Medical, and fellowship support from Biosense Webster.