[Catheter ablation of atrial fibrillation].
In patients with drug-refractory atrial fibrillation, left-atrial catheter ablation represents a new curative therapeutic option. Segmental ostial or circumferential pulmonary vein isolation can achieve stable sinus rhythm in some 70% of patients with paroxysmal atrial fibrillation but no severe structural heart disease. In patients with chronic atrial fibrillation, complex left-atrial linear, or substrate-oriented ablation strategies may additionally be applied. In patients with cardiac insufficiency or more severe systolic left-ventricular dysfunction, restoration of a stable sinus rhythm through the use of left-atrial catheter ablation can improve the left-ventricular ejection fraction and reduce the severity of cardiac failure. Potential complications of ablation include, in particular, pulmonary veins stenosis, iatrogenic left-atrial tachycardia, thromboembolic events and fatal atrio-esophageal fistulas.
Reithmann
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Medizinische Klinik I, Klinikum Grosshadern, Universität München. Christopher.Reithmann@med.uni-muenchen.de
Remp
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D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects; D002908:Chronic Disease; D004937:Esophageal Fistula / Q000209:etiology; D006333:Heart Failure; D006801:Humans; D007049:Iatrogenic Disease; D013318:Stroke Volume; D013610:Tachycardia / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology; D018487:Ventricular Dysfunction, Left