With great pride, Alfaisal University, College of Medicine, would like to congratulate Ali Hassan Mushtaq, a 3rd year medical student, for being the only student from Alfaisal University to win in the KSAUHS’ Health Professions Conference 2019, where he managed to win the 6th place out of more than 180 competing medical students and doctors, for the research entitled: “Aggressive ablation strategy for Persistent Atrial Fibrillation Ablation leads to better Outcomes: A Single Center Study”
Mushtaq, A1,2, Haj Aissa, N1,2 , ALbunni, H1,2 , Barbour, M1,2 , Aldohan, N1,2 , Swarup, V2
1= Alfaisal University, College of Medicine, Riyadh, KSA
2= Arizona Heart Rhythm Center, Cardiac Electrophysiology, 500 W, Phoenix, USA
Objectives: Different atrial fibrillation (AF) ablation strategies lead to variable outcomes, and the most appropriate method for ablation remains a controversial topic, especially in persistent AF. We aim to evaluate the outcomes of aggressive ablation strategy with targeting of all inducible reentrant circuits in order to achieve non-inducibility.
Methods: We retrospectively examined 425 patients who underwent cardiac radiofrequency catheter ablation (RFA) in 2017 from a single high-volume ablation practice in the US over one calendar year. 279 had AF ablation and of these, 137 had three-dimensional electrical mapping data available, and non-inducibility was assessed. Patients were divided into two cohorts of paroxysmal (n=92) and persistent (n=45) AF. Success rates along with other comparisons were made for each group.
Results: Non-inducibility had been achieved in 137 patients with an overall catheter ablation procedure success rate of 79.6% (73%, persistent; 82.6%, paroxysmal). On average, patients with persistent AF required substrate modification (SM) (roof, mitral isthmus, anterior septal wall, and coronary sinus) more frequently than paroxysmal AF patients (91.1%, persistent;60.0%, p; p-value <0.003). Moreover, left atrial (LA) volume and the number of lesions in the persistent population was significantly higher than the paroxysmal population (p = 0.001 and p = 0.003 respectively). Additionally, comorbidity comparison was statistically insignificant between the two cohorts except for CHF, more common in the persistent population.
Conclusion: Aiming to achieve non-inducibility in both populations by aggressive catheter ablation leads to higher success rate. Thus, mode of presentation should not predict the need for SM as long as non-inducibility is achieved.
We wish him all the best, and hope this will provide motivation to all Alfaisal students to achieve the highest positions in all scientific competitions and events.