Substrate Remodelling and Targeted Ablation in AF

Atrial fibrillation (AF) is a very common heart condition where your heart beats irregularly. Millions of people in the UK experience symptoms like palpitations (a fluttering heart), feeling tired, and breathlessness. It can also increase your risk of stroke and heart failure, so finding effective treatments is really important.

One common treatment is called catheter ablation. This procedure involves doctors guiding thin wires into your heart, usually from a blood vessel in your leg. They then use controlled energy to carefully target and correct the areas causing your heart to beat irregularly. However, this procedure doesn't always work perfectly, and about half of patients find their AF returns, meaning they might need further treatment or continue to live with the condition.

This study, taking place at St Bartholomew's Hospital, wants to make catheter ablation more effective. Researchers will use advanced mapping techniques to create a very detailed 3D picture of your heart's upper left chamber. This picture will show them exactly how electrical signals travel through your heart, highlighting any abnormal areas or scarring. They'll also look at nerve activity. By understanding these tiny details, they hope to figure out why AF keeps coming back in some people and how to improve ablation procedures. All participants will have this special mapping done during their ablation. If AF returns, some patients might be offered a second, specially targeted ablation based on what the maps showed. The researchers will then follow patients for 12 months to see if this detailed mapping leads to better, longer-lasting results, reduces the need for more procedures, and ultimately improves patients' quality of life.