Current strategies in the management of atrial fibrillation.
Treatment of atrial fibrillation (AF) has been undergoing significant changes recently. This is due partly to different mechanisms proposed for persistent and permanent AF and partly due to the introduction of energy-based techniques, providing less invasive procedures. This article aims to review the mechanisms of AF leading to the changes in clinical practice and to review the results of surgery, energy-based, and percutaneous techniques. It is difficult to compare and contrast the results of reported series in the literature due to different definitions of AF; freedom from and recurrence of it. Furthermore, in most series it is difficult to distinguish results of surgery for lone AF and AF associated with valvular heart disease and coronary artery disease.
Jahangiri
Marjan
M
Department of Cardiac Surgery, St. George's Hospital Medical School, London, United Kingdom. marjan.jahangiri@stgeorges.nhs.uk
Weir
Graeme
G
Mandal
Kaushik
K
Savelieva
Irina
I
Camm
John
J
D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D019090:Case Management; D017115:Catheter Ablation / Q000379:methods; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000379:methods; D004554:Electric Countershock; D004699:Endocardium / Q000601:surgery; D005725:Ganglia, Autonomic / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D008872:Microwaves / Q000627:therapeutic use; D008955:Models, Cardiovascular; D010138:Pacemaker, Artificial; D010496:Pericardium / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011667:Pulmonary Veins / Q000294:innervation / Q000601:surgery