Catheter ablation for atrial fibrillation
Gauri, Andre J. and Knight, Bradley P. (2003) Catheter ablation for atrial fibrillation. Indian Pacing and Electrophysiology Journal, 3 (4). pp. 210-223. ISSN 0972-6292
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Atrial fibrillation (AF), the most common arrhythmia in adults, affects 1 in 25 people over the age of 60 years and 1 in 10 over the age of 80 years.1 There is considerable morbidity, mortality and economic burden associated with AF, all of which will increase with the expanding elderly population. Until recently, pharmacologic therapy with AV nodal blocking agents, antiarrhythmics and anticoagulation were the mainstay of therapy. Although electrical cardioversion is associated with a high immediate success rate, most patients have recurrences of AF with only 23% remaining in sinus rhythm one year after cardioversion.2 Antiarrhythmic agents have been shown to improve sinus maintenance, but these medications have variable success and are associated with many potentially serious side effects. In addition, the recently published AFFIRM trial suggests that a pharmacological rhythm control strategy has no benefit in terms of mortality or morbidity over a rate control and anticoagulation strategy.3 Over the last few years, there has been a great deal of enthusiasm regarding catheter based ablation strategies aimed at curing AF.
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