A ground-breaking step to improve cardiac care in Australia has been taken, as funding is announced for a clinical quality registry to improve outcomes following Atrial Fibrillation (AF) ablation. Led by Alfred Hospital's Head of Electrophysiology, Professor Peter Kistler, The Australian Registry for the Ablation of Atrial Fibrillation (AuRA-AF) brings together Australia's leading clinical experts and researchers in AF ablation, and leverages the world-class registry science expertise housed within Monash University's Centre of Cardiovascular Research and Education in Therapeutics (CCRET).
The AU$7 million funding over five years was secured under the Medical Research Future Fund (MRFF) – 2024 Enhancing Medical Device Surveillance Through Registries grant scheme.
AF is an irregular heart rhythm caused by chaotic electrical impulses that elevate the heart rate and often cause palpitations. Untreated, it can increase a person's risk of blood clots, stroke, heart failure, vascular conditions including some dementias, and early death.
500,000 Australians are affected, resulting in over 200,000 hospital admissions every year.
Ablation is a percutaneous procedure that blocks the abnormal electrical signals. It is the most effective treatment for AF and lifechanging in many, although costly and complex with variable outcomes; patients may require multiple procedures and can experience significant complications. Some of this variation in outcomes is determined by clinician training and level of experience.
The new national registry is an extraordinary collaboration between fifty chief investigators, which will see Australia's leading electrophysiologists, cardiologists, healthcare providers, and consumer groups, uniting with leading cardiac research institutions including Monash University, the Baker Heart and Diabetes Institute, University of Melbourne and the University of Adelaide.
Joining Professor Peter Kistler as Clinical Leads are Professor Jonathan Kalman (University of Melbourne), and Professor Prashanthan Sanders (University of Adelaide) – both long-time champions of improving outcomes for AF through high-quality ablation services and extensive research programs in Australia.
There are currently wide disparities in access to AF ablation across Australia, with First Nations Peoples 1.8 times less likely to receive the procedure, and women, rural residents, and those in disadvantaged areas also facie reduced access. The new registry has engaged First Nations representation on the Steering Committee, and will retain a separate First Nations Committee.
Speaking on behalf of the investigator team, CIA Professor Kistler says, "The vision for this registry is grounded in equity and partnerships – forged specifically to transform the safety and quality of AF care, and to address the unacceptable variation in access to ablation services we see currently."
"This represents a major change in our ability to work together in a coordinated and rigorous way to achieve better outcomes for the half a million Australians with AF – some of whom are only in their 20s or 30s when first diagnosed."
Clinical quality registries capture standardised data that is analysed and reported back to clinicians, to help them benchmark their performance and identify areas for improvement. The AF ablation registry will integrate patient-reported outcome measures to ensure the outcomes that matter most to patients are addressed. It'll also enable cost-effectiveness analyses, and serve as a platform for clinical trials to accelerate evidence into practice.
Co-Director of Monash University's CCRET, Cardiologist-researcher Professor Dion Stub, serves as the Data Custodian on the project.
He says, "We've seen clinical quality registries deliver measurable improvements in patient outcomes across a range of disciplines and diseases such as coronary artery and valvular heart disease. It's fantastic to see the sheer number of partners uniting on this registry, which will help us rapidly engage with ablation providers to contribute their data and propel us towards national coverage as soon as possible."
The CCRET will deliver the registry, which will sit alongside four other cardiac clinical quality registries based in the School of Public Health and Preventive Medicine that monitor a range of cardiac surgeries and medical devices across Australia.
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