A clinical trial in progress at Royal Brompton Hospital aims to significantly improve treatment for patients with atrial fibrillation (AF) by removing some of the heart's nerve endings.

The procedure - carried out for the first time ever and led by expert consultants - involves using an innovative imaging technique to help identify the exact locations of a branch of nerves, known as the sympathetic nervous system, which are thought to be one of the underlying causes of AF. The nerve endings are then targeted for catheter ablation treatment, where radiofrequency energy is used to destroy areas of heart tissue.

The ongoing trial, ‘A Pilot Study on the Role of Ganglionated Plexus Ablation for Catheter Ablation of Atrial Fibrillation’ is being led by Dr Sabine Ernst, consultant cardiologist and electrophysiologist at Royal Brompton Hospital. 

Commenting on the trial, Dr Ernst said:

“Standard catheter ablation in patients with paroxysmal (‘on-off’) atrial fibrillation has a 60 to 75 per cent success rate. We believe that treating these sympathetic nerve endings as well as the patient’s pulmonary veins could increase the benefits of catheter ablation significantly. This method may potentially mean that many AF patients do not have to undergo repeat procedures, or experience unpleasant symptoms such as recurrent palpitations.

“Initial results associated with this new technique have been promising. Of the small number of patients treated, most have returned to a normal heart rhythm and have seen their symptoms disappear. This method tries to reduce the activity of the sympathetic nervous system so it works in a more balanced way with the parasympathetic nervous system. The trial will help establish the best way to carry out this technique to ensure just the right level of adjustment is achieved for each patient.”


Dr Sabine Ernst

Consultant cardiologist and electrophysiologist