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Vol 76, No 12 (2018)
REVIEWS
Published online: 2018-11-07
Submitted: 2018-11-05
Accepted: 2018-11-07
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Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challengesCatheter ablation of atrial fibrillation: current status, techniques, outcomes, and challenges

Gerhard Hindricks, Alireza Sepehri Shamloo, Radosław Lenarczyk, Zbigniew Kalarus, Arash Arya, Simon Kircher, Angeliki Darma, Nikolaos Dagres
DOI: 10.5603/KP.a2018.0216
·
Pubmed: 30406938
·
Kardiol Pol 2018;76(12):1680-1686.

open access

Vol 76, No 12 (2018)
REVIEWS
Published online: 2018-11-07
Submitted: 2018-11-05
Accepted: 2018-11-07

Abstract

Atrial fibrillation (AF) is the most common human arrhythmia. Interventional treatment with catheter ablation is an established technique that is increasingly applied and has become one of the main treatment modalities in patients with AF. Ablation results in significant improvement of symptoms and the quality of life. There is as yet no clear evidence of any impact of the procedure on hard clinical endpoints, except in patients with heart failure, who seem to benefit significantly from ablation. The cornerstone of the procedure is the achievement of pulmonary vein isolation. Radiofrequency energy is the main applied energy source, but cryoballoon ablation has emerged as a safe and effective alternative to radiofrequency ablation. Additional ablation strategies and novel technical features have been proposed but without unequivocal proof of clinical benefit. The most promising of these seems to be substrate mapping of the left atrium with substrate modification in areas with low voltage as an adjunct to pulmonary vein isolation. Complication rates remain considerable despite accumulated experience and can be partly reduced by application of preventive measures.

Abstract

Atrial fibrillation (AF) is the most common human arrhythmia. Interventional treatment with catheter ablation is an established technique that is increasingly applied and has become one of the main treatment modalities in patients with AF. Ablation results in significant improvement of symptoms and the quality of life. There is as yet no clear evidence of any impact of the procedure on hard clinical endpoints, except in patients with heart failure, who seem to benefit significantly from ablation. The cornerstone of the procedure is the achievement of pulmonary vein isolation. Radiofrequency energy is the main applied energy source, but cryoballoon ablation has emerged as a safe and effective alternative to radiofrequency ablation. Additional ablation strategies and novel technical features have been proposed but without unequivocal proof of clinical benefit. The most promising of these seems to be substrate mapping of the left atrium with substrate modification in areas with low voltage as an adjunct to pulmonary vein isolation. Complication rates remain considerable despite accumulated experience and can be partly reduced by application of preventive measures.

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Keywords

atrial fibrillation, catheter ablation, complications

About this article
Title

Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challengesCatheter ablation of atrial fibrillation: current status, techniques, outcomes, and challenges

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 12 (2018)

Pages

1680-1686

Published online

2018-11-07

DOI

10.5603/KP.a2018.0216

Pubmed

30406938

Bibliographic record

Kardiol Pol 2018;76(12):1680-1686.

Keywords

atrial fibrillation
catheter ablation
complications

Authors

Gerhard Hindricks
Alireza Sepehri Shamloo
Radosław Lenarczyk
Zbigniew Kalarus
Arash Arya
Simon Kircher
Angeliki Darma
Nikolaos Dagres

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