Cardiac Arrhythmias in the year Review: 2015-2016 Dr Reginald Liew MA, MB BS (Hons), PhD, FRCP, FACC, FESC, FAsCC Director/ Senior Consultant Cardiologist The Harley Street Heart and Cancer Centre Mount Elizabeth Novena Specialist Centre, Singapore Outline of presentation • • • • AF ablation strategies AF ablation techniques Other arrhythmias ICDs and advances in pacing Outline of presentation • • • • AF ablation strategies AF ablation techniques Other arrhythmias ICDs and advances in pacing Verma et al for the STAR AF II Investigators N Engl J Med 2015; 372:1812-182 STUDY QUESTION• What is the optimal strategy for ablation of persistent AF? Does the addition of CFAE and linear ablation add any benefit to PVI alone? METHODS • 589 patients with persistent AF randomly assigned in a 1:4:4 ratio to ablation with PVI alone (67 patients), PVI plus ablation of CFAEs (263 patients), or PVI plus additional linear ablation across the left atrial roof and mitral valve isthmus (259 patients) • The duration of follow-up was 18 months • The primary end point was freedom from any documented recurrence of AF lasting longer than 30 seconds after a single ablation procedure STAR II study results- Freedom from AF RESULTS • Procedure time was significantly shorter for PVI alone than for the other two procedures (P