Atrial fibrillation – advancing mapping and ablation strategies to improve cure rates and patient outcomes

Cabrini Research recognises and awards researchers for their commitment and passion and outstanding research outcomes every year.

In 2021, we recognised the exemplary research of Professor Peter Kistler, awarding the Publication of the Year Award for his paper ‘Alcohol abstinence in drinkers with atrial fibrillation’. It had global impact and was published in the prestigious New England Journal of Medicine.

A clinician cardiologist and electrophysiologist, Prof Kistler is an internationally renowned leader in the treatment and research of heart rhythm disorders. Atrial fibrillation (AF) is the most common heart rhythm disturbance world-wide and increases the risk of stroke, heart failure and mortality. It is estimated more than 5% of the patient population over 55 years of age has AF. In 2018, AF was listed as an associated cause of 11,960 deaths in Australia (7.6% of all deaths), a number which has almost doubled between 2001 and 2018.

Prof Kistler’s New England Journal of Medicine publication was the first randomised study to determine the impact of alcohol abstinence on AF, demonstrating that abstinence from alcohol reduces arrhythmia recurrences in regular drinkers with AF. The study significantly strengthened the role of lifestyle interventions, which are now referred to as the fourth pillar in AF management. Population studies have long demonstrated an association between alcohol and AF but alcohol counselling was not routinely performed. As a result of Prof Kistler’s study, alcohol reduction is now included in the American Heart Association lifestyle guidelines in management of AF. Prof Kistler’s research has attracted worldwide media attention including the front page of The Age and featured on Channel 7 and 10 National News. He was also awarded the RT Hall Prize in 2020 (outstanding cardiac researcher from Cardiac Society Australasia) in part as recognition of this publication.

Catheter ablation is the only form of cure

Catheter ablation is an internationally recognised treatment for AF that is suitable for some patients with AF. Catheter ablation uses small burns (radiofrequency) or freezing (cryoballoon) to induce scarring on the inside of the heart that breaks up the electrical signals that cause the AF, restoring a normal heartbeat. Although there have been significant advances in our understanding and technology, there remains a substantial proportion of patients who experience recurrent AF requiring repeat procedures. The optimal approach to ablative management for recurrent AF remains unclear.

Prof Kistler is driving novel research that will facilitate improvements in treatment, through cutting edge mapping and catheter ablation techniques for AF. Cabrini delivers more than 300 AF ablation procedures per year and ranks as one of the busiest catheter laboratories in Australia. The research will have incredible impact for not only our patients, but patients worldwide.