Activity Description

This enduring educational activity reviews existing practice gaps with traditional Atrial Fibrillation treatment strategies, and examines the structural mechanistic basis of Persistent Atrial Fibrillation, and clinical evidence supporting Hybrid Endocardial/Epicardial Ablation and Posterior Wall Isolation. The leading experts also evaluate the rationale and design of the CONVERGE and DEEP Trials.

This activity was created from the live proceedings of a satellite symposium held at Heart Rhythm 2018.

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Access Presentation

Webcast

Click on the session title listed below to view each presentation.

	Insights into the Structural and Mechanistic Basis of Persistent Atrial Fibrillation: Arguments Supporting Hybrid Endocardial/Epicardial Ablation and Posterior Wall Isolation. Kevin Makati, MD, FACC, FHRS
	Convergence of Epicardial and Endocardial RF Ablation for the Treatment of Symptomatic Persistent AF David DeLurgio, MD, FACC, FHRS
	DEEP Trial: Hybrid Ablation Kenneth Ellenbogen, MD
	Panel Discussion Panel: David DeLurgio, MD, FACC, FHRS, Kenneth Ellenbogen, MD, Kevin Makati, MD, FACC, FHRS

 

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Commercial Supporter

This activity is supported by an educational grant from AtriCure

Joint-Providers

MediaSphere Medical, LLC and Ciné-Med

 

Faculty

Faculty

	David DeLurgio, MD, FACC, FHRS Professor of Medicine Division of Cardiology, Department of Medicine Emory University School of Medicine Atlanta, GA
	Kenneth Ellenbogen, MD Martha M. and Harold W. Kimmerling Professor of Cardiology Chair, Cardiology VCU School of Medicine Richmond, VA
	Kevin Makati, MD, FACC, FHRS Rhythm Section Chairperson, Baycare Health Systems Co-Director Arrhythmia Department, St. Joseph’s Hospital Tampa, FL

 

 

CME/CE Test

1. Achieving Optimal Outcomes for Persistent Atrial Fibrillation Patients through Hybrid Ablation
2. Please enter your information, and complete the following CME post test and evaluation form. Upon successful completion, your submission will be reviewed and you will receive notification shortly regarding the status of your certificate. You must achieve a minimum score of 70% to earn credit for this activity.
   
   
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12. 
    1. The posterior wall has been shown to harbor AF triggers, and proves to be a viable ablation target.
    
13. Select one*  
    A) True.
    B) False.
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14. 
    2. Ablation of the posterior wall decreases AF beyond PVI.
    
15. Select one*  
    A) True.
    B) False.
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16. 
    3. The study purpose of the CONVERGE IDE Clinical Trial is to evaluate the safety and efficacy of the Epi-Sense® - AF Guided Coagulation System with VisiTrax® for the treatment of symptomatic persistent Atrial Fibrillation (AF) patients refractory or intolerant to at least one Class I and/or Class III anti-arrhythmic drug (AAD).
    
17. Select one*  
    A) True.
    B) False.
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18. 
    4. The objective of the DEEP Pivotal Trial is to establish the safety and effectiveness of a dual epicardial and endocardial ablation procedure for patients presenting with Persistent AF or Longstanding AF.
    
19. Select one*  
    A) True.
    B) False.
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20. 
    5. The primary effectiveness endpoint of the DEEP Trial is freedom from any documented AF, atrial flutter, or atrial tachycardia lasting >30 seconds in duration through the 12 month follow-up visit in the absence of Class I or III AADs (with exception of previously failed AADs at doses not exceeding those previously failed.
    
21. Select one*  
    A) True.
    B) False.
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22. 
    6. Atrio-esophageal fistula (AEF) is a rare complication which can occur in any procedure that involves ablation near the posterior wall of the left atrium.
    
23. Select one*  
    A) True.
    B) False.
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24. 
    7. Which risk mitigating actions proposed to the FDA to reduce the risk of AEF is accurate?
    
25. Select one*  
    A) A proton-pump inhibitor (PPI) must be prescribed to the patient for a minimum of 7 days prior to both epicardial and endocardial procedures and continued for a minimum of 30 days post procedure.
    B) Visualize the esophagus before any ablation, (by withdrawal of the TEE probe while visualizing the endoscope and TEE probe).
    C) Visualize and lift up on the devices during ablation (Clamps and Coolrail/MLP away from the esophagus).
    D) Allow the lesions to cool with Coolrail/MLP before letting the ablated areas down on the pericardium. Use an irrigator to Quench the ablated areas in the pericardial space for 30 seconds. (Use devices to lift tissue away from esophagus while ablating).
    E) Subject Awareness/Follow-up/Patient wallet cards.
    F) All of the above.
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26. 
    Although optional, we respectfully request that you complete the activity evaluation form, since your feedback assists in the development of future educational activities.
27. 
    Background
    

    Please rate each question using a scale of 1 to 5 (1 = Beginner, 5 = Advanced)
28. 
    I would consider my level of expertise in the subject matter prior to the webcast as:
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29. 
    I would consider my level of expertise in the subject matter after the activity
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30. 
    Considering my experience and background, the material presented was:
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31. 
    Extent to which activity met the identified objectives
    Please rate each question using a scale of 1 to 5 (1 = Not Met, 5 = Completely Met)
32. 
    Review structural and mechanistic basis of Persistent Atrial Fibrillation, and clinical evidence supporting Hybrid Endocardial/Epicardial Ablation and Posterior Wall Isolation.
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33. 
    Evaluate the rationale and design of the CONVEREGE Trial for the treatment of Symptomatic Persistent Atrial Fibrillation.
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34. 
    Examine the rationale and design of the DEEP Trial for the treatment of subjects with Persistent or Longstanding Persistent Atrial Fibrillation.
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35. 
    Information Presented
    Please evaluate the information that was presented by answering Yes, No, Maybe or Not Applicable
36. 
    Reinforced my current practice/treatment habits:
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37. 
    Will improve my practice/patient outcomes:
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38. 
    Enhanced my current knowledge base:
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39. 
    Provided new ideas or information that I expect to use:
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40. 
    Information gained from this conference will result in making a change in your practice:
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41. 
    Future activities on this subject matter is important to my practice:
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42. 
    Addressed a professional practice gap:
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43. 
    Was free of commercial bias/influence:
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44. 
    What barriers do you anticipate in incorporating best practices learned in this activity into clinical activities or quality improvement initiatives at your institution?
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45. 
    What mechanisms can you identify to overcome these barriers?
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