Navigating the Future of Atrial Fibrillation Care

Atrial fibrillation (AF) is the most common cardiac arrhythmia in adults, increasing the risk of stroke five-fold and represents a growing epidemic and public health burden. 1 It is due to abnormal electrical activity within the atria of the heart, causing them to fibrillate, and is characterized by tachyarrhythmia, which means that the heart rate is too fast. 2 Due to its rhythm irregularity, blood flow through the heart becomes turbulent and has a high chance of forming a thrombus (blood clot), which can ultimately dislodge and cause a stroke. 2 The lifetime risk of developing AF is approximately 1 in 4, and the estimated worldwide prevalence of AF during the next 30 years is projected to increase by 66% reaching 62.5 million cases. 1 Furthermore, AF is the most significant cause of cardioembolism, with AF-related ischemic stroke being twice as likely to be fatal, usually more severe, or recurs more frequently than non-AF stroke. 1

Previously, physicians terminated arrhythmias using surgical manoeuvres, with the first surgical “maze procedure” being performed in 1987. 3,? Some 11 years after the first maze procedure was performed saw the introduction of less invasive radiofrequency catheter-based techniques, quickly becoming the preferred interventional therapy mode. ? In recent years, sophisticated new mapping techniques have further elucidated the underlying electrophysiology of AF, and the optimal interventional therapeutic approach for individual patients has become clearer. ? Indeed, significant progress has been achieved in understanding AF initiation and maintenance, as well as treating disease substrates and complications. ? Catheter ablation has revolutionized arrhythmia treatment and is an interventional therapy that uses radiofrequency energy to destroy a small area of heart tissue that is causing arrhythmia. 3 Destroying this abnormal tissue without damaging the rest of the heart helps restore the heart’s regular rhythm. 3

Such rapid progress has seen the development of MicroPort? EverPaceTM‘s Columbus? 3D EP Navigation System and FireMagic? 3D Irrigated Ablation Catheter. Together, these devices provide physicians with a comprehensive solution for diagnosing and treating arrhythmias.

The Columbus? 3D EP Navigation System is a magnetic- and impedance-based system for electrophysiological mapping and positioning of the atria and ventricle. Combined with the magnetic positioning functions of the diagnostic & ablation catheters and external reference patch, it can use higher location accuracy and mapping efficiency to create the 3D model of the heart cavity in real-time – a crucial feature, given that ineffective identification of the site of the phrenic nerve can lead to complications like pulmonary vein stenosis and phrenic nerve damage. 3 When used with a force-sensing catheter, it provides real-time measurement of the contact force between the catheter tip and contacting tissue. Furthermore, the Columbus? 3D EP Navigation System reduces radiation exposure and procedure time for patients and physicians, a distinctive benefit given that the incidence of thromboembolic events is common with increased ablation time. 3 Finally, its more powerful ECG module allows stimulation event recording and ECG auto morphology comparison, and when used with the matching invasive blood pressure sensor and blood oxygen probe, it can monitor the invasive blood pressure and pulse oximetry saturation.

With its novel design, the FireMagic? 3D Irrigated Ablation Catheter allows physicians to effectively manoeuvre it during procedures for an optimized ablation result by providing a precise location of the catheter curve in the body and collecting cardiac ECG signals. Furthermore, the tip electrode allows for accurate 3D positioning, and multiple embedded sensors realize real-time curve visualization. When combined, these design elements provide physicians with a crucial tool that can have a role in preventing atrioesophageal fistula, a complication that can occur when a catheter is placed incorrectly or imprecisely. ? With open irrigation providing uniform cooling of the tip electrode, ensuring stable power delivery, the FireMagic? 3D Irrigated Ablation Catheter offers consistent performance and comfortable catheter control during complex and extended procedures.

Catheter ablation is a rapidly evolving field and has proven to be a valid solution for many patients suffering from arrhythmias. MicroPort? EverPaceTM proudly continues accelerating access to innovative medical devices that help physicians deliver patient-centred care when treating AF so patients everywhere can live better and longer lives.

Learn more about EverPaceTM: www.everpace.com

Learn more about MicroPort?: www.microport.com

References:

1.???? Choi SE, Sagris D, Hill A, Lip GY, Abdul-Rahim AH. Atrial fibrillation and stroke. Expert Rev Cardiovasc Ther 2023;21(1):35-56.

2.???? Nesheiwat Z, Goyal A, Jagtap M. Atrial Fibrillation [online]. 2023. Apr 26 [cited 2024, Apr 15]. Retrieved from: URL: https://www.ncbi.nlm.nih.gov/books/NBK526072/ .

3.???? Ghzally Y, Ahmed I, Gerasimon G. Catheter Ablation [online]. 2023, Jul 30 [cited 2024, Apr 16]. Retrieved from: URL: https://www.ncbi.nlm.nih.gov/books/NBK470203/ .

4.???? McCarthy PM, Cox JL, Kislitsina ON, Kruse J, Churyla A, Malaisrie SC, et al. Surgery and catheter ablation for atrial fibrillation: history, current practice, and future directions. J Clin Med 2021;11(1):210.

5.???? Bhat A, Khanna S, Chen HH, Gupta A, Gan GC, Denniss AR, et al. Integrated care in atrial fibrillation: a road map to the future. Circ Cardiovasc Qual Outcomes 2021;14(3):e007411.

6.???? Leung LW, Akhtar Z, Sheppard MN, Louis-Auguste J, Hayat J, Gallagher MM. Preventing esophageal complications from atrial fibrillation ablation: a review. Heart Rhythm O2 2021;2(6):651-64.

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