[Interventional treatment for paroxysmal atrial fibrillation : which is the optimal ablation approach?]

A Sultan, J Lüker, T Plenge, D Steven
Herz 2015, 40 (1): 25-30
Atrial fibrillation is one of the most common arrhythmias and effects probably more than 35 million people worldwide. The incidence in patients older than 70 years of age is as high as 10%. One can expect that according to our demographic development this entity will be increasingly important within the next years and decades. Along with the well know and established but at the same time limited opportunities of pharmacological treatment option of this arrhythmia, catheter ablation has evolved as a safe and effective treatment option. Electrical isolation of the pulmonary vein remains the standard of care and results in success rates as high as 80% using modern ablation strategies. Optimization of procedural and ablation techniques has lead to this high success rates. Different energy sources are available, such as radiofrequency, cryoenergy and laser are widely used today to treat patients with symptomatic atrial fibrillation. PV isolation using a so called "single-shot" ablation approach has shown to be effective with a reduced requirement of periprocedural resources and therefore resulting in wider application of this treatment not only in specialized electrophysiological centers. The rapid development in this field leads to the question which approach can be used as the most likely to result in the highest success and least complication rates. This question will be addressed in the following manuscript.

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