Catheter ablation for atrial fibrillation in 2007

Overview

Atrial fibrillation (AF) is the most frequent clinical arrhythmia in humans and its prevalence is continuously increasing. Frequent failures of drug therapy have contributed to the development of non-pharmacological methods of treatment. In addition to surgical ablation, several strategies of catheter ablation have been gradually introduced. These consist of the application of radiofrequencies into proximal segments of pulmonary veins, their vestibules and the posterior wall of the left atrium and/or into regions with fractionated potentials. The main goal is to electrically isolate foci in muscular sleeves around pulmonary veins that trigger arrhythmia or to modify a substrate in atrial myocardium, especially in the vestibular regions of pulmonary veins.

There is also a growth in experience with the treatment of chronic AF. The efficacy in curing AF ranges between 70-90 %, according to the population studied, treatment technique, follow up strategy and frequency of follow up visits. Curative catheter ablation for AF has crossed over from the clinical experimental stage and has become standard procedure in selected centres. Novel techniques are being studied in order to make the procedure simpler and faster. Catheter ablation even has the potential to become the first line treatment in many patients with AF.

Key words:
atrial fibrillation, catheter ablation, heart failure.