[Current strategies of pharmacological and non-pharmacological treatment in atrial fibrillation and atrial flutter].
The current information regarding mechanistic understanding of atrial fibrillation(AF) and flutter(AFL) is reviewed, and the recent development in both pharmacological and non-pharmacological treatment for AF and AFL is also introduced. For the antiarrhythmic therapy, the effectiveness and safety of new class III drugs(ibutilide and azimilide) in the termination and prophylactic therapy are focused. In the non-pharmacological section, several ablative strategies including electrical isolation of PV-LA interface for focal AF, 'Ablate and Pace' therapy and AV nodal modification for drug-refractory tachycardic AF, and so-called 'Hybrid' therapy are introduced. It is emphasized that the newly developed 3-dimensional mapping system is useful to determine the appropriate target site of ablation for atypical AFL.
First Department of Internal Medicine, Nippon Medical School.
Yoshinori
Y
Kobayashi
D001281:Atrial Fibrillation / Q000209:etiology / Q000628:therapy*; D001282:Atrial Flutter / Q000209:etiology / Q000628:therapy*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000379:methods; D002986:Clinical Trials as Topic; D004594:Electrophysiology; D006801:Humans; D006827:Hydantoins; D007093:Imidazoles / Q000627:therapeutic use; D048289:Imidazolidines; D010138:Pacemaker, Artificial; D010879:Piperazines / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
D006827:Hydantoins; D007093:Imidazoles; D048289:Imidazolidines; D010879:Piperazines; D013449:Sulfonamides; C067192:ibutilide; C086123:azimilide