Interview with Dr. Andrea Natale at Boston Atrial Fibrillation Symposium 2010
January 21, 2010 12:17 AM CT
In this video from Boston Atrial Fibrillation Symposium 2010, Dr. Andrea Natale discusses new directions in afib treatment, including hybrid procedures combining catheter ablation and surgery for chronic or persistent atrial fibrillation, and contact force sensing for determining the force applied during catheter ablation.
Dr. Natale is the Executive Medical Director of the Texas Cardiac Arrhythmia Institute at St David’s Medical Center in Austin, TX.
View the video of Dr. Natale at Boston Atrial Fibrillation Symposium 2010:
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Mellanie True Hills: This is Mellanie True Hills, from Stopafib.org, I’m at Boston Atrial Fibrillation Symposium 2010, and I’m talking with Dr. Andrea Natale, whom many of you know as one of the rock stars of the catheter ablation space. He has agreed to share with us about some of the future directions for catheter ablation and the afib space. Dr. Natale is the executive medical director of the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center in Austin, Texas, and also practices at some other locations around the country. Dr. Natale, thank you so much for joining us today, and we’re excited to know what are some of the future directions for catheter ablation and for treating afib patients?
Dr. Andrea Natale: Thank you, Mellanie, for this opportunity. There are two main things we have learned in the last few years that relate to the difficult group of patients, which are the patients with long-standing persistent atrial fibrillation. We have learned that, in that group, we really have to try to individualize the approach to be able to target areas that really are outside of the conventional region that we address in the typical patient. And because of that, catheter ablation in some of these patients might have some limitations, so we recently explored what we call “hybrid approaches”, which are procedures where we combine the benefit of the surgical minimally-invasive strategy and the catheter-based strategy.
There are two ways we are doing this today. We are a little bit more experienced with the product produced by nContact, and we’re now in the process of finalizing the protocol with another company, AtriCure. The philosophy is to really combine the advantages of both procedures. Obviously, this is something that is difficult to predict the way it is going to pan out, but we sort of are hopeful that at least we’re going to learn what is best for the patient. Honestly, I feel that we’re going to be able to do better than what we do with either catheter-based alone or a surgical procedure alone. So I’m somewhat excited about this opportunity because it is going to really help us to manage more efficiently a patient with more difficult atrial fibrillation.
MTH: Are there any other really exciting things on the horizon that you’d like to share with us?
Dr. Natale: Well, from our perspective, I think contact force [sensing] is something that we realize is very important to try to improve what we do with catheters. One of the issues that we have with catheter-based procedures is that the lesion that we create is not necessarily permanent, and this affects the success rate. If we have a way to assess the contact between the catheter and the tissue, that can help us to do a better job. So I’m confident that this technology is going to improve the efficacy, and maybe the safety, also, of catheter-based procedures. So that’s one area. The other regions of importance, especially in the non-paroxysmal patient, such as the coronary sinus and the left atrial appendage, are areas where you want to know how much pressure you apply to the tissue, because if you do too much, that certainly can result in a complication. So I see this as a tool that is going to be valuable to people who perform catheter-based procedures.
MTH: Excellent. Dr. Natale, thank you so much for sharing with us today. This is Mellanie True Hills, for StopAfib.org.