Nonpharmacologic therapies for atrial fibrillation

The American Journal of Cardiology
D KeaneJ Ruskin

Abstract

The limited efficacy and proarrhythmic risks of antiarrhythmic drug therapies for atrial fibrillation have led to the exploration of a wide spectrum of alternative therapeutic approaches. The diversity of the approaches is warranted by the current absence of a single procedure that can safely and effectively cure atrial fibrillation. The interventional therapies that are currently under most active development include implantable atrial defibrillator therapy, prophylactic atrial pacing in combination with drug therapy, multisite regional pace-entrainment of atrial fibrillation by rapid pacing, atrial surgery, and catheter ablation for atrial fibrillation. The current limitations of these procedures include: (1) for the implantable atrial defibrillator--patient tolerance of low energy shocks and early recurrence of atrial fibrillation; (2) for prophylactic pacing-limited efficacy in a small proportion of the total atrial fibrillation population; (3) for multisite regional pace-entrainment--lack of proved efficacy and difficulty in the expansion and merging of the entrained regions; (4) for atrial surgery--highly invasive as a stand-alone procedure; and (5) for catheter ablation-lack of proved long-term efficacy, shortcomings of ...Continue Reading

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Citations

May 6, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Abraham G KocherilJon E Block
Aug 14, 2002·Clinical Cardiology·Fu Siong Ng, A John Camm
Aug 5, 2000·Primary Care·T E Applegate
May 24, 2000·The American Journal of Cardiology·D S Cannom

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