Atrial Myopathy: Is it Time for a New Atrial Fibrillation Classification System?

Interview With Philipp Sommer, MD

In this onsite interview at the Western Atrial Fibrillation (AFib) Symposium, we talk with Philipp Sommer, MD, from Herz- und Diabeteszentrum NRW in Bad Oeynhausen, Germany.

Please introduce yourself.

My name is Philipp Sommer. I am the director of the Clinic of Electrophysiology at the Herz- und Diabeteszentrum NRW in Germany.

What can you tell us about your presentation at Western AFib? 

The question I was addressed was “Do we need a new classification for AFib?” Of course, if I am addressed a question like that, the answer must be yes, there must be a new classification needed! Right now, we basically categorize AFib according to this clinical presentation: when the episodes are very short, we call it paroxysmal, and when they are longer or if cardioversion is needed, which means an electrical shock of the heart, we call it persistent. However, this is a really rough estimate of what is going on in the heart. Today, we still know the most about AFib once we have the heart examined with our catheters. We are currently looking for better methods to predict those findings with our catheters, because this would allow us to exclude patients from an ablation procedure, identify optimal candidates for certain technologies (eg, a single-shot device creating cryo lesions), or identify patients who would be optimal for a pulse field ablation procedure or radiofrequency ablation (ablating with heat). So, we have different tools available, and the task and challenge for the coming years will be to assign the individual patient to his or her optimal technology.

What are some of the take-home messages you would like viewers to leave with? 

The take-home message is that classifying our patients into paroxysmal and persistent is just not detailed enough. It is not coming close to the truth. We need better information and tools in our hands to classify our patients and get a better idea of what is going on in these individual patients. That means we have to include parameters such as the electrocardiogram or imaging data from computed tomography or magnetic resonance imaging, and all of this cannot be done by ourselves. We need the help of artificial intelligence to get all this information.

What is your favorite part about Western AFib?

There is not any sort of AFib meeting in the world with this type of faculty. Everyone you know and everyone you want to hear discuss a certain topic is here. It is really a “Who’s who”! It is fabulous and it makes it really unique. Nassir Marrouche sets up this meeting with an outstanding faculty.