In this episode:

• Oral antiarrhythmics have limited efficacy and significant risks
• Catheter ablation is now a first-line option in suitable patients
• Newer ablation technology – Pulsed field ablation (PFA) is safer and faster
• Anticoagulation decisions remain based on stroke risk, not ablation status
• Genuine post-procedural issues may be benign
• Ongoing healthcare professional role – Blood pressure and risk factor control

The questions answered in this podcast are listed below.
They were compiled by GPs and health professionals around Australia who attended Healthed’s face-to-face seminars.

1. How effective are oral antiarrhythmic medications?
2. Does this cure atrial fibrillation?
3. What is the current state of ablation technology?
4. Can you explain what you mean by “rapid” and provide an example of how long a procedure typically takes?
5. Does reduced scarring decrease the likelihood or complexity of needing a repeat ablation?
6. What are some of the contraindications in terms of structurally abnormal heart that would be contraindications for the patient?
7. How should atrial fibrillation be approached in patients with severe ischaemic heart disease? Does this complicate treatment?
8. If a patient has an AF ablation, can they come off my anticoagulant?
9. How do you manage patient’s embolic issues?
10. How soon after the procedure can patients typically be discharged?
11. Following successful AF suppression, is it possible for patients to stop taking DOACs or other anticoagulants?
12. After discharge, how soon should patients follow up with their GP?
13. What should the GP monitor and what should be communicated back to the specialist?
14. When will you consider AV node ablation and insertion of a pacemaker?

Expert: Prof Rukshen Weerasooriya, Cardiac Electrophysiologist

Host: Dr David Lim, GP and Medical Educator

Total time: 44 mins

Recommended resources:

• 2023 Cardiac Society of Australia and New Zealand expert position statement on catheter and surgical ablation for atrial fibrillation
• Catheter ablation for atrial fibrillation – Patient information booklet | Heart Rhythm Clinic
• Atrial fibrillation – Information sheet for practitioners | CloudHolter
• Using wearable devices for cardiac arrhythmia diagnosis – An information sheet | CloudHolter
• Discharge information: Pulmonary vein isolation | Heart Rhythm Clinic
• Ectopic beats | CloudHolter
• Alcohol abstinence in drinkers with atrial fibrillation | The New England Journal of Medicine
• Cryoablation or drug therapy for initial treatment of atrial fibrillation | The New England Journal of Medicine
• Atrial fibrillation ablation – Your questions answered: Part 1 | Healthed