Progress in Nonpharmacologic Therapy of Atrial Fibrillation

Packer, Douglas L.; Asirvatham, Sam; Munger, Thomas M.

doi:10.1046/j.1540-8167.2003.90403.x

Cited by 63 publications

(32 citation statements)

References 93 publications

(186 reference statements)

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“…779 While the success rate was approximately 40% to 50%, a relatively high complication rate diminished enthusiasm for this approach. 105 The observation that potentials arising in or near the ostia of the PV often provoked AF, and demonstration that elimination of these foci abolished AF escalated enthusiasm for catheter-based ablation.…”

Section: Catheter Ablationmentioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Fuster¹,

Rydén²,

Cannom³

et al. 2006

Circulation

1,879

589

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Section: Catheter Ablationmentioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Fuster¹,

Rydén²,

Cannom³

et al. 2006

Circulation

1,879

589

View full text Add to dashboard Cite

“…Although the trigger plays the major role in paroxysmal AF, as cardiopathy develops, atrial substrate becomes more important. 27 The present study population consisted of patients with persistent AF with little atrial dilation. In these patients, the relative importance of trigger and substrate has not yet been defined clearly.…”

Section: Hypothesis For Different Procedural Successmentioning

confidence: 99%

Radiofrequency Ablation of Atrial Fibrillation

et al. 2008

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Background-Several approaches have been developed for radiofrequency catheter ablation of atrial fibrillation, but the correct intraprocedural end point is still under debate, and few data exist about the destiny of ablation lesions over time. The aim of the present study was to evaluate the long-term maintenance of intraprocedural end points of ablation procedures. Methods and Results-Inclusion criteria were (1) a previous ablation procedure of pulmonary vein (PV) encircling performed for drug-refractory persistent atrial fibrillation; (2) a "complete" intraprocedural end point, which consisted of voltage abatement inside the lesions, PV disconnection, and exit-block pacing from inside the lesions, attained in all PVs; and (3) stable sinus rhythm documented during a minimum follow-up of 2.5 years after the procedure. Twenty volunteers were selected (12 males, mean age 59Ϯ7 years) and underwent a repeat electrophysiological study. After a follow-up of 36.4Ϯ4.7 months, complete voltage abatement was maintained around 32 PVs (40.0%), PV disconnection persisted in 12 (37.5%) of the previously isolated PVs, and exit block was present in 39 PVs (48.7%). Ten patients who underwent a redo ablation procedure because of recurrences of atrial fibrillation were used as the control group. Differences in intraprocedural end-point maintenance between the 2 groups were not statistically significant. Conclusions-Common intraprocedural end points such as voltage abatement, PV disconnection, and exit block persist only in a limited number of patients, even when the outcome is favorable during follow-up. Further investigation will be required to determine whether such data will have implications for ablation strategies.

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“…Les premières procédures d'ablation par radiofréquence cherchaient à reproduire le Maze chirurgical par la création de lésions linéaires dans l'endocarde atrial [37]. Les modestes taux de succès (40% à 50%) associés à un risque relativement élevé de complications ont toutefois freiné l'enthousiasme pour cette technique [1].…”

Section: Ablation Par Radiofréquenceunclassified

Mécanismes physiopathologiques de la fibrillation auriculaire

2008

Schweiz Ärzteztg

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SummaryThe pathophysiology of atrial fibrillation is complex, and appears to result from the interaction between initiating triggers, often in the form of rapidly firing ectopic foci located in the pulmonary veins, and an abnormal atrial tissue substrate capable of maintaining the arrhythmia through mechanisms such as multiple wavelet reentry or multiple rotors. Moreover, atrial remodelling, autonomic tone variations and inflammation also may be involved in the genesis and maintenance of atrial fibrillation. Ultimately, the recent understanding of some of these mechanisms has led to new therapeutic strategies, such as radiofrequency catheter and surgical ablation techniques. At the present time, a strategy of radiofrequency catheter ablation tailored to the burden of atrial fibrillation allows efficient management of patients, with a high rate of long-term freedom from recurrence of atrial fibrillation.

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Progress in Nonpharmacologic Therapy of Atrial Fibrillation

Cited by 63 publications

References 93 publications

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Radiofrequency Ablation of Atrial Fibrillation

Mécanismes physiopathologiques de la fibrillation auriculaire

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