We have located links that may give you full text access.
JOURNAL ARTICLE
REVIEW
Non-pharmacological treatments for atrial fibrillation. A critical perspective on the status quo.
In a proportion of patients with atrial fibrillation, antiarrhythmic drugs are either ineffective, unsafe, or poorly tolerated. Accordingly, a variety of non-pharmacological treatments have been developed. This article critically reviews these modalities. (i) For ventricular rate control, catheter ablation of the atrioventricular node with pacemaker implantation is commonplace. An alternative is atrioventricular node modulation using a procedure similar to "slow pathway" ablation. (ii) For restoration of sinus rhythm, internal cardioversion using low energy shocks is highly effective; this has prompted the development of atrial and dual chamber defibrillators. (iii) To eliminate the atrial fibrillation substrate, a number of surgical procedures have been developed, of which the most effective is the "Maze" operation. The efficacy of this operation cannot be reproduced by conventional catheter ablation, and current research is concentrating on simplified procedures using new catheter designs for linear ablation. (iv) Finally, pacemakers and catheter ablation may be used to suppress the triggers for atrial fibrillation episodes. A number of atrial algorithms are under investigation for overdrive suppression of ectopy, and the use of multisite atrial pacing to alter the atrial response to ectopy has shown promising results. Catheter ablation has shown considerable success in preventing "focal" atrial fibrillation that is triggered or driven by ectopy arising usually from the pulmonary veins. To date, there are few data regarding the long-term efficacy and safety of these techniques, and their effects on quality of life. However, ongoing multicentre trials addressing these issues are expected to report over the next few years.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app