Updated approach to atrial fibrillation for GPs
Shownotes
In this episode of The Good GP, host Dr Ash Bowden is joined by Professor Rukshen Weerasooriya, Clinical Professor of Medicine at UWA and cardiac electrophysiologist, to discuss the updated management of atrial fibrillation (AF) and what this means for general practitioners.
Professor Rukshen explains the recent introduction of pulsed field ablation, a non-thermal technique that has made AF ablation procedures faster and safer by reducing complications such as esophageal and nerve injury. This development has expanded the availability of ablation and changed practice guidelines, now recommending ablation earlier in a patient’s AF journey rather than as a last resort.
Key risk factors and modifiable contributors to AF outcomes are discussed, including limiting alcohol, achieving weight loss (especially a 10% reduction for overweight patients), managing blood pressure, and treating sleep apnea.
Also covering expected success rates, stressing that ablation is highly effective (up to 90% suppression in ideal patients) but not curative, and early referral to a cardiac electrophysiologist, ideally within the first year of diagnosis, maximises patient benefit. Highlighting the key investigations to organise before referral: ECG, echocardiogram (especially for left atrial size and ventricular function), and Holter monitoring.
The broader significance of AF is addressed, with its rising prevalence, elevated stroke and heart failure risk, and the psychological burden on patients underscored as reasons to prioritise detection and early, proactive management.
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