The effect of Ablation on Ganglionic Plexi
Research type
Research Study
Full title
The effect of Epicardial Ablation on Ganglionic Plexi during Hybrid Atrial Fibrillation Ablation
IRAS ID
199173
Contact name
Guy Furniss
Contact email
Sponsor organisation
Plymouth Hospitals NHS Trust
Duration of Study in the UK
1 years, 3 months, 30 days
Research summary
Atrial Fibrillation (AF) is a common condition that affects the electrical and mechanical function of the upper chambers of the heart – the left and right atria. This leads to a lack of synchronized contraction of the atria and an irregular pulse. Palpitations, fatigue and a decreased exercise tolerance can be common complaints and lead to multiple hospital admissions and a significant reduction in quality of life.
Paroxysmal AF (episodes that last less than 1 week) symptoms can be diminished or eliminated by electrically isolating the pulmonary veins (veins from the lungs to the left atrium) via a catheter passed from the patient’s groin – so called pulmonary vein isolation (PVI). This will ‘cure’ or eliminate AF symptoms in over 80% of patients. However, for patients with persistent AF (episodes lasting longer than 1 week), PVI is rarely enough to restore normal rhythm, further ablation is needed but there remains debate over the optimal strategy required to treat persistent AF.
Standard catheter ablation provides long-term freedom from AF in less than 60% of patients but Hybrid atrial fibrillation ablation via a first stage surgical epicardial (from the outside of the heart) approach followed by a second stage catheter endocardial (from the inside) approach has been shown in some series to be successful in 80%. Reasons suggested for this are a superior lesion set, better isolation of the posterior wall of the left atrium and better targeting and ablation of ganglionic plexi (GP).
Ganglionic plexi are nerves that innervate the heart which act as triggers for AF episodes, targeting of GP has been shown to improve outcomes. This study will look at the effect of epicardial ablation on GP response increase our understanding of the additional benefits of epicardial ablation in persistent atrial fibrillation.REC name
South West - Frenchay Research Ethics Committee
REC reference
16/SW/0072
Date of REC Opinion
26 Apr 2016
REC opinion
Further Information Favourable Opinion