Matthew McKillop (Jacksonville, US) presented advancements in non-pulmonary vein atrial fibrillation (AF) ablation using STAR mapping, a technique developed by Rhythm AI. STAR mapping, integrated with the Abbott EnSite X system, identifies early sites of activation and repetitive activation patterns through stochastic trajectory analysis. The STAR Apollo study, targeting persistent AF post-pulmonary vein isolation, recently completed enrolment. Dr McKillop demonstrated how the system provides real-time data, guiding targeted radiofrequency ablation to discrete sites while avoiding unnecessary tissue damage. The session highlighted the importance of strategic ablation, with a focus on patient outcomes rather than extensive lesion creation.

Panelists Arian Sultan (Cologne, DE) and Roland Tilz (Lübeck, DE) joined Chair Devi Nair (Jonesboro, US) in discussing the approach’s implications. Topics included the importance of right atrial mapping in redo procedures, consistency in mapping signals and the impact of inducible AF in lab settings. The session underscored the need for precision in ablation strategies and the potential of software-assisted mapping to refine treatment decisions. Dr McKillop emphasised a philosophy of minimal but effective ablation, prioritising patient-specific mapping over widespread lesion sets to improve AF management.