CALLEN LECTURE 2016
The Atrial Fibrillation Epidemic in the US: Future of Ablation and Other Therapies.
Dr. Douglas L. Packer delivers the Callen Lecture
Dr. Douglas Packer, Professor of Medicine at Mayo Clinic, Rochester, Minnesota delivered the 28th annual Irwin R. Callen, MD Memorial Lectureship, the "Legacy of Knowledge" on August 21, 2016 at the Florida Chapter of American College of Cardiology's annual meeting at Disney Resort, Orlando, Florida.
Dr. Packer's presentation "The Atrial Fibrillation Epidemic in the US: Future of Ablation and Other Therapies" examined the problem of a type of heart rhythm irregularity, atrial fibrillation, and reviewed currently available approaches to treat this disorder.
Atrial fibrillation has become more frequent over the past decade and Dr. Packer's primary focus was catheter ablation which is a procedure used to selectively treat areas of the heart that cause this rhythm problem.
The most recent data indicates that the upswing in atrial fibrillation is due to hypertension, diabetes, heart failure and myocardial infarctions as major risk factors. There are also a number of emerging minor risk factors including obstructive sleep apnea, excessive exercise, inflammatory abnormalities and atrial fibrosis.
Unfortunately, medical therapy has been partly effective. On the other hand, increasing data suggest that ablation for atrial fibrillation may be even more effective for eliminating this arrhythmia, particularly in patients with paroxysmal or early persistent atrial fibrillation. The CABANA trial, which has recently completed enrollment, will provide substantial information regarding which approach to treatment of atrial fibrillation is best. While radiofrequency ablation has been a mainstay for ablative intervention, recent studies have shown the effectiveness of cryo ablation therapy, laser ablation and ablation using contact force catheters. In addition, we are currently working on several new approaches for ablating atrial fibrillation including the use of particle therapy, where carbon atoms are delivered through the chest wall to eliminate atrial fibrillation without requiring catheters. We now have substantial data on the use of this approach and see it as emerging into the clinical arena within the next year or so. This presentation will review currently available approaches to atrial fibrillation and those that are anticipated in the next 3-4 years. This is a particularly important time for clinicians in dealing with the acceleration of atrial fibrillation occurrence with both pharmacologic and nonpharmacologic approaches.