Non-pharmacological treatment from the point of view of recent recommendations for the treatment of patients with atrial fibrillation
Authors:
A. Bulava
Authors place of work:
Kardiocentrum Nemocnice České Budějovice
Published in the journal:
Kardiol Rev Int Med 2011, 13(3): 143-152
Summary
Non-pharmacological treatment from the point of view of recent recommendations for the treatment of patients with atrial fibrillation. Catheter therapy of atrial fibrillation was established in the late 1990s. Initial pioneer attempts at focal catheter ablation within the pulmonary veins have recently been superceded by novel and clinically tested approaches. Despite the introduction of sophisticated techniques for the procedure and increased clinical knowledge of this arrhythmia, the main principle applied during ablation has not been changed – wide antral isolation of pulmonary veins or other thoracic veins or other thoracic veins complemented by a series of linear or non-linear lesions either in the left or both atria has remained a cornerstone of the procedure. Notwithstanding the enormous effort to achieve a similar clinical success rate as in AV nodal re-entry tachycardia, WPW syndrome or typical atrial flutter, we are witnessing a relatively low long-term success rate, most likely due to the fact that atrial fibrillation is a unique phenomenon, with a continuously evolving arrhythmic substrate. This article summarizes new guidelines for the non-pharmacological treatment of atrial fibrillation and simultaneously gives an overview of the current clinically used technologies for the catheter and surgical ablation.
Keywords:
catheter ablation – atrial fibrillation – guidelines – success rate – novel technologies
Zdroje
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Štítky
Paediatric cardiology Internal medicine Cardiac surgery CardiologyČlánok vyšiel v časopise
Cardiology Review
2011 Číslo 3
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