Published: 27-05-2024 08:50 | Updated: 03-06-2024 15:45

New thesis encourages earlier discharges after catheter ablation of atrial fibrillation

Astrid Paul Nordin from the Heart and Lung Diseases Unit at the Department of Medicine, Huddinge (MedH) is defending her thesis titled "Catheter ablation of atrial fibrillation - methods for improving outcome", on 31 May, 2024. Main supervisor is Nikola Drca (MedH).

Astrid Paul Nordin.

What is your thesis about?

My thesis is about catheter ablation of atrial fibrillation and includes an evaluation of whether it is safe to discharge patients on the day of ablation. The thesis also includes validation of an ECG device to detect atrial fibrillation. I have also evaluated factors that can predict left atrial scar areas, which are unfavourable for freedom from atrial fibrillation after ablation treatment. Finally, I have evaluated whether symptoms of acid reflux and heartburn are associated with left atrial scar areas.

The most extensive work partly included in the thesis is an ongoing randomised trial (IDEAL-AF) that aims to find out whether additional ablation of left atrial scar areas is beneficial. The study protocol for this trial is included in the thesis.

What are the main findings?

The results show that discharging the patient on the day of the procedure is patient-safe in the majority of patients. We have also been able to show that the Coala Heart monitor, which is a handheld ECG device, has good reliability in detecting atrial fibrillation.

Furthermore, the results show that predictors of left atrial scarring were female gender, advanced age, history of myocardial infarction or angina and enlarged left atrium. Gastroesophageal reflux disease was identified as an independent predictor of left atrial posterior wall scarring.

How can this knowledge benefit people?

This knowledge can lead to earlier discharge after ablation of atrial fibrillation, which is beneficial both for the patient and in terms of resource utilisation in healthcare.

As we have demonstrated the reliability of the Coala Heart Monitor, its use may increase, both in the follow-up of AF patients and in AF screening.

The results on left atrial scarring may help healthcare providers to identify patients at high risk of scarring, which may help to correctly plan the ablation procedure. In addition, insights into the relationship between gastroesophageal reflux disease and left atrial scarring increase our understanding of atrial scarring.

What are your goals for the future?

I want to complete the ongoing IDEAL-AF randomised fibrillation ablation trial, the results of which will contribute to recommendations for fibrillation ablation.

Several sub-studies on the IDEAL-AF material have been initiated and are planned to be completed.