Atrial fibrillation: new approaches to intervention treatment
Bokeriia, L.A.; Revishvili, A.S.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk 1: 4-9
2009
ISSN/ISBN: 0869-6047 PMID: 19253685 Document Number: 636947
New technologies for electrophysiological diagnosis of atrial fibrillation make possible elucidation of the mechanisms of the development and maintenance of arrhythmia and detection of the so-called arrythmogenic pulmonary veins. Radiofrequency ablation procedure (especially at the posterior wall of the left atrium) includes, besides electrical isolation of pulmonary veins, partial (parasympatic) denervation of the heart that also influences the efficiency of interventional treatment of atrial fibrillation (AF). Modem methods of interventional treatment help to efficaciously manage paroxysmal AF in 85-90% of the patients by means of radiofrequency ablation (RIA) of pulmonary veins. Combination of linear RIA and variants of the "Labyrinth" procedure using the CARTO non-fluoroscopic mapping system makes it possible to treat chronic and persisting forms of AF in patients with the left atrial volume up to 180 ml. A new algorithm for management of AF refractory to preventive anti-arrhythmic therapy.