Abstract
The 2019 European Heart Rhythm Association (EHRA) scientific meetings released several Late Breaking Clinical Trials that define important results for the fields of catheter ablation of atrial fibrillation (AF) and ventricular tachycardia (VT). Three independent multicenter randomized controlled trials have confirmed that AF ablation with point-by-point radiofrequency energy or cryoballoon technology are both equally and highly effective, and significantly superior to antiarrhythmic drug therapy in reducing recurrent AF episodes and preventing arrhythmia-related hospitalizations. Edoxaban has been shown a viable option for periprocedural oral anticoagulation in patients undergoing catheter ablation of AF in a large multicenter randomized study, with outcomes similar to uninterrupted warfarin. Important mechanistic studies have evaluated the electrophysiologic features of concealed substrate in reperfused myocardial infarction (MI) with small electrode mapping, and investigated the longitudinal evolution of the arrhythmogenic substrate following acute MI. Finally, encouraging results from multicenter observational studies support the emerging role of imaging integration with cardiac magnetic resonance or computed tomography to guide substrate ablation of VT. This article will provide an update on some of the most relevant studies in the field of catheter ablation of AF and VT presented at the latest EHRA conference.
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