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AF causes a marked reduction in cardiac performance leading

to breathlessness, syncope and disabling palpitations. It is also

strongly associated with stroke, a complication which can be

avoided with proper use of oral anticoagulants. Despite its

importance, AF remains poorly understood and there are

wide variations in how it is managed by clinicians.

Over the past 10 years, there have been dramatic advances

in treatments available for AF, in particular, the development

of percutaneous catheter ablation. In the past, patients were

considered untreatable and the disease was allowed to follow

its own natural course. However, more recently there has

been a drive by many cardiologists to restore and maintain

sinus rhythm over the long-term. In parallel with this, however,

there have been claims from other cardiologists that this is

the wrong approach, claiming that AF should be managed

conservatively, using just Warfarin to prevent stroke, and

drugs such as Digoxin to keep the patient’s ventricular rate


A consequence of this ongoing debate is that many non-

specialists are now confused and uncertain how to best manage

their AF patients.

This seminar hopes to clarify AF management

for GPs by reviewing these controversies and offering simple


In addition, a live AF ablation case will be performed


see figure1

) which we hope will demystify this procedure and

demonstrate that, for appropriate patients, it is a safe and

effective way of treating this common condition.

Figure 1

: Left atrium of a patient undergoing AF ablation.The

image has been reconstructed from a CT scan and is used to

guide the ablation catheter around the chamber, so that ablation

can be delivered at the pulmonary veins, the usual source of AF.

The Modern

Management of AF

Who should haveWarfarin?

Who should be cardiover ted?

Is there a cure?

Who should use treatment

and what should it be?

All of these common questions will

be answered for you at our seminar.

Seminar for GPs at London Bridge Hospital with Live

Case Demonstration

Atrial Fibrillation (AF) is the most

common cardiac arrhythmia

Seminar – Thursday 7th February 2008

Programme -

7th February 2008



Mark Earley

12:00 - 12:20

AF – is it safe to ignore or

should we try and restore

sinus rhythm in everyone?

Mark Earley

12:20 - 12:40

A quick guide to restoring

and maintaining sinus


Simon Sporton

12:40 - 13:00

Warfarin – who needs it?

Mark Earley

13:00 - 13:15

Catheter ablation of AF –

the patient journey

Claire Chitty

13:15 - 13:20

Introduction of case

Richard Schilling

13:20 - 14:00 Lunch

14:00 - 16:00

Ablation of paroxysmal AF.

Live case performed at

London Bridge Hospital

by Dr Richard Schilling

During case Catheter

ablation of AF: strategy

and how it is done

Simon Sporton


Close of meeting


Claire Chitty

Arrhythmia Nurse Specialist,

London Bridge Hospital

Mark Earley

Consultant Cardiologist, St Bartholomew’s

Hospital and London Bridge Hospital

Richard Schilling

Consultant Cardiologist, St Bartholomew’s

Hospital and London Bridge Hospital

Simon Sporton

Consultant Cardiologist, St Bartholomew’s

Hospital and London Bridge Hospital

Figure 1