The AFIB Report

Your premier information resource for atrial fibrillation


EDITORIAL

Number 141
December 2015/January 2016
17th Year

Welcome to this belated Decí15 / Janí16 issue of The AFIB Report. Weíre still in the midst of our website redesign and likely will be until mid-autumn time frame, based on best current estimates. We have several choices for the look of the site now that will be finalized end of July, after which the pace will all pick up substantially from there. Not surprisingly, this project is a big one, and Iím looking forward to finally opening the doors to the new website for all our readers and forum members.

In this issue, we start with a review of an important international multicenter study that gives direct evidence to the efficacy of addressing the posterior left atrial wall (LAPW) as a key step in an extended PVAI ablation protocol for all classes of afibbers, from paroxysmal to long standing persistent cases.

I was impressed, but not surprised, by such solid proof now showing that these extended ablation techniques, properly executed and used in the right patient groups, reliably confer what so many on our forum have anecdotally experienced as excellent long-term freedom from arrhythmia. What is unique, is that this study design included confirming both durable LAPW isolation and PVAI as well. For the first time directly validating that documented durable LAPW isolation leads to significantly improved persistent AFIB ablation outcomes (and for most paroxysmal cases too).

Next up, is an in-depth follow-up report on rotor-mapping technology that we first examined in our last issue with a thorough look at the state of FIRM-mapping and ablation technology, and where it stood as of last Feb. 2016. In that initial report, we reviewed a preliminary Group 1 arm of the complete and larger OASIS-Randomized Control Trial (RCT) that was due for May í16 release at the HRS conference.

In light of the dismal results from that first arm of OASIS looking at 29 non-paroxysmal cases undergoing FIRM-Only ablation with no companion PVAI, I had noted that perhaps results from the complete OASIS-RCT, as the first and so far only formal RCT yet done on FIRM, might yet show a ray of light for the almost 5-year-old and still controversial and embattled technology.

As such, we now wrap-up our marathon investigation into the Ďstate of FIRMí circa July 2016, to see if any greater confidence was inspired by a thorough review of the completed OASIS-RCT presented at this yearís large Heart Rhythm Society Scientific Sessions in May at San Francisco.

Our third contribution in this issue is a succinct overview of the nutraceutical supplement and amino-acid L-Theanine and its impact on Brain health by Jackie Burgess RDH.

Finally, we wrap up this belated first issue of 2016 with an inspiring personal story from a physically fit 68-year-old Canadian man, Richard D., from Calgary. Richard contacted me in mid-May seeking advice for a possible ablation. Heís a very avid golfer, and after having a coronary bypass graft surgery (CABG) a bit over 2 years ago, developed persistent AF which is not uncommon after CABG. Over the past 1.5 years Richardís AFIB became long-standing persistent, and his local EP informed him he was no longer a candidate for ablation or even ECV!

Needless to say, there is much more to Richardís story. And he asked if he could share his experience with our readers, feeling certain many may relate and appreciate what he had gone through. I think you all will enjoy reading about Richardís fast transformation back to the links!

I much appreciate, too, all of your patience during this lengthy website revamp and the inevitable issue delays.

Be well all and enjoy unbroken NSR!

Shannon



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