Noninvasive electrocardiographic imaging–guided targeting of drivers of persistent atrial fibrillation: The TARGET-AF1 trial

[www.heartrhythmjournal.com]

[www.ahajournals.org]

What is an AF Driver ablation?

It just means sources of afib. In this case they're referring to sources other than the pulmonary veins. The second article you linked to also refers to FIRM ablations, and you can pretty much ignore any study involving FIRM. It was a nice theory but it didn't hold up.

Thanks Carey but why would they brand a new trial (Target AF1 trial) when many experienced/top tier EPs already ablate areas other than PVI areas? It’s nothing new then. Their success rate seems high for an index ablation considering one doesn’t know the skill set of the EPs.

How could they ablate 181 driver areas in radiofrequency delivery time of 38.9 ± 14.1 minutes? That seems kind of fast and aggressive burns. I don’t know if anyone who had 181 burns. I always get the hospital ablation report and it gives minute by minute burn counts. Especially seems high if 181 drivers are only in the PVI.



Edited 1 time(s). Last edit at 07/12/2022 11:38AM by susan.d.

There are still EPs out there hitching their wagon to the FIRM horse and that's pretty much what they're talking about in that study, but they don't use the term FIRM. They refer to "rotational" drivers. Well, that's what FIRM was all about: this idea that there are "rotators" in the atria that sustain afib. Natale has poo-pooed the concept from the beginning and has largely been proven right. Incidentally, I had a FIRM ablation in 2014. It added hours to the procedure and accomplished nothing more than creating more burn tissue than necessary in my left atria and left me with 250 bpm flutter. Also, that was a small study and the success rates they quote don't impress me.

If I'm reading the abstract correctly, the 181 burns were across the entire study group, not a single patient.

Quote
Carey
There are still EPs out there hitching their wagon to the FIRM horse and If I'm reading the abstract correctly, the 181 burns were across the entire study group, not a single patient.

I didn’t see that. Still…it’s a waste of grant money since it isn’t a new successful technology.