2010s: EP and Pacing

Abstract

In this last decade, with further maturity of catheter ablation for AF, the multicenter CABANA trial demonstrated AF ablation to be safe, more effective compared to drugs, and likely having an early role in the CHF patient. Newer energy sources for accomplishing ablation with enhanced precision and safety are in their formative stages: particle beam radiation and electroporation advancing rapidly.

Understanding what are true genetic mutations that cause arrhythmogenic pathology versus background noise has been emphasized in this decade. “Big data” has come of age, with huge data registries serving as parallel testing forums for randomized trials as well as the emerging clinical tool: artificial intelligence. At the close of the decade, AI coupled with the ECG, consumer monitoring, and the digitized medical record appear to be an extremely powerful triad, which will allow at-a-distance management of individual patients and populations using the developing Mayo healthcare platform.