The Heart Has a Roof Line? Anatomy and New Ablation Techniques - 2025 Quality Summit Presentation (Non-CE)-The Heart Has a Roof Line? Anatomy and New Ablation Techniques

Video Transcription

Video Summary

Dr. Haissam Ismail presented on advances in atrial fibrillation (AFib) ablation, focusing on cardiac anatomy, ablation techniques, and energy sources including pulse field ablation (PFA). AFib prevalence is rising, especially with an aging population and improved diagnostics. Ablation is now a class I recommended treatment, more effective than drugs, and it slows disease progression. Initially, ablations focused on isolating pulmonary veins, pivotal triggers in early AFib. As AFib becomes persistent, additional areas like the posterior wall, left atrial appendage, and right atrium are targeted. PFA, a non-thermal technique causing cell death via electroporation, offers safety advantages over traditional thermal methods like radiofrequency and cryoablation, minimizing injury to surrounding tissues such as the esophagus and nerves. Clinical trials show PFA is as effective as thermal ablation but with shorter procedure times and improved safety. Mapping techniques help identify arrhythmic substrates and guide ablation lines, improving outcomes. Dr. Ismail emphasized the importance of detailed documentation and data submission to the NCDR registry to track quality and facilitate research on optimal ablation strategies. Overall, early rhythm control with ablation—especially using novel modalities like PFA—improves outcomes and may reduce AFib progression. The session concluded with discussion on asymptomatic AFib, pharmacologic strategies post-ablation, and coding/documentation challenges related to new technologies.

Keywords

intravascular imaging

percutaneous coronary intervention

PCI

IVUS

OCT

cardiovascular care

coronary CT angiography

CTFFR

interventional cardiology

atrial fibrillation

AFib ablation

pulse field ablation

cardiac anatomy

ablation techniques

non-thermal ablation

clinical trials

NCDR registry