Hey everybody, I'm Dr. Morales,
I'm here at the Heart Rhythm Society,
I'm with Dr. Jonathan Salcedo
who is an electrophysiologist in the Palo Alto area.
Dr. Salcedo thanks for taking a few minutes
out of your time for this conference.
- Thank you for having me.
- So we're going to be talking about new things.
We're going to be talking about changes and progressions
for technology when it comes to AFib ablations.
Now, you know people out there, they're kind of concerned.
They're all, well, ablations don't work, you know.
Or they know that people need multiple ablations,
so sometimes people feel that it's not worth it,
or it's not going to work.
But you know obviously we come to a big conference like here
and we realize there's new stuff coming out,
there's always new research on how to do an ablation better,
so, so what are some of the great things that you
have talked about, and experienced you know,
that are new frontiers for ablation?
- Sure, you know, this is an exciting time,
it's been exciting for the last 10 years,
and the first thing I'd like to say is
ablations do work. - Yeah.
- It's been proven, our guidelines have changed
to reflect that, and we're just getting better.
The technologies are getting better,
the things we've seen here at the conference
so far are very exciting.
From, you know, freezing power, RF power,
to electroablation, there's a lot of things
around the corner that will make this
even safer than it is, and it's already safe,
and, and my group has published about that.
We are particularly interested in
high-power, short duration.
My group has been doing it for over 10 years,
along with a few other centers,
and you know that, that is just gonna, you know
the data about that is going to keep getting better.
Obviously the companies are also catching up
and starting to come up with their own technologies,
- Yeah.
- And you know the important thing is that it's safe,
and you know we've shown that in our recent article,
over 11,000 patients.
With these new technologies it'll be definitely
be more adoptable for everyone,
and you know we are excited about that.
- And you know, when it comes to ablations you know,
pre-history of recurrences you know,
I tell people, you know despite the fact that
we're intentionally trying to create scar tissue
when doing ablation, the heart can be resilient.
The heart can grow back, and to the lay person
you know, they may say,
"well, what's so hard about ablating tissue, you know?"
But then you have a good point you know,
there's so many ways to do it, you know,
and there's different energy types,
there's different methods and different ways to do it.
- And every patient's heart's different.
- Yes, exactly.
- Their, their tissue qualities are different,
so you know, their, it, it is definitely
not a simple procedure,
but it is very effective, and we are finding ways to
do this for everyone safely and to make their lives better.
To live their lives the way they want to, active,
and enjoying life, and not on medications
that are slowing them down. - Yes.
And that's exactly the point that I bring up
for a calmly you know,
an ablation procedure works better than any medication,
to control symptoms, keep people out of the hospital,
and live the life that they want to.
- Exactly, exactly.
- What about people who are in maybe in more advanced
stages of AFib?
Is there anything new that you've seen,
or in your practice, that you would say,
yeah you know, even for more advanced stages of AFib
we're getting better at this.
- Yeah, no, that's definitely probably the biggest
opportunity for, for discovery.
You know we don't know, we don't have the best idea,
we've just saw that the you know rotor mapping
may not be the answer, probably is not the answer
at this point, so yeah we are still searching.
We, we all do a little bit different things for it,
I think the you know, the best thing would be to prevent
from going into long, long-standing persistent
and I think the awareness is getting out there,
and, and I think referring earlier,
you know, is, the better-- - Yes.
- See an electrophysiologist as early as possible.
But for those that are in long-standing persistent,
yes, you know we are trying to develop ways to map it,
ways to ablate it,
and we don't have the answers yet,
but I feel you know, it's, it's around the corner as well.
- And that's something I talk about with my patients,
I, I think that when things will get better
for these more advanced type of AFib,
is there's got to be a way to customize it somehow,
because AFib affects everybody's heart differently.
And no matter how long you've had AFib,
your heart's going to look differently than
the next person who has AFib, - Right.
- So you have to kind of be able to find a way to
figure out, in that particular person,
- Right.
- What is the main concentration of AFib?
- I think that is, that is the golden question
that we're all trying to, you know we want to make
it patient specific. - Yeah.
- Right now we're doing a you know a standard ablation set
for everyone, and that's just,
we know that's a big limitation.
It works, but, it's you know we're not,
we're not at you know the success rates
that we want to be at.
And I think finding that answer, like I said,
is the golden question that, that will you know
help us make that big advance,
you know next big advance, in our success rates.
- Well, a lot of great insight here
in the Heart Rhythm Society conference,
great things coming out,
good things for patients to look forward to,
So I'd like to say thank you for taking
a few minutes out of your time, to give us your insight
- No worries. - Thank you.
- I appreciate it. - I appreciate it.