title: Management of refractory atrial fibrillation post surgical ablation.
abstract: Over the past two decades, invasive techniques to treat atrial fibrillation (AF) including catheter-based and surgical procedures have evolved along with our understanding of the pathophysiology of this arrhythmia. Surgical treatment of AF may be performed on patients undergoing cardiac surgery for other reasons (concomitant surgical ablation) or as a stand-alone procedure. Advances in technology and technique have made surgical intervention for AF more widespread. Despite improvements in outcome of both catheter-based and surgical treatment for AF, recurrence of atrial arrhythmias following initial invasive therapy may occur.Atrial arrhythmias may occur early or late in the post-operative course after surgical ablation. Early arrhythmias are generally treated with prompt electrical cardioversion with or without antiarrhythmic therapy and do not necessarily represent treatment failure. The mechanism of persistent or late occurring atrial arrhythmias is complex, and these arrhythmias may be resistant to antiarrhythmic drug therapy. The characterization and management of recurrent atrial arrhythmias following surgical ablation of AF are discussed below.
authors: Al-Sabah Arrhythmia Institute (AI), St. Luke's Hospital, NY, USA ;
authors: Robert K
authors: RK
authors: Altman
authors: McGill University Health Centre, Montreal, Canada ; ; Ospedale Sacco, Milan, Italy ;
authors: Riccardo
authors: R
authors: Proietti
authors: Al-Sabah Arrhythmia Institute (AI), St. Luke's Hospital, NY, USA ;
authors: Conor D
authors: CD
authors: Barrett
authors: Department of Heart and Vessel, University of Florence, Florence, Italy ;
authors: Alessandro
authors: A
authors: Paoletti Perini
authors: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA ;
authors: Pasquale
authors: P
authors: Santangeli
authors: Ospedale Sacco, Milan, Italy ;
authors: Stephan B
authors: SB
authors: Danik
authors: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA ; ; Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY, USA ; ; Department of Biomedical Engineering, University of Texas, Austin, TX, USA ; ; Department of Cardiology, University of Foggia, Foggia, Italy ;
authors: Luigi
authors: L
authors: Di Biase
authors: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA ; ; Department of Biomedical Engineering, University of Texas, Austin, TX, USA ; ; Division of Cardiology, Stanford University, California, USA ; ; Case Western Reserve University, Cleveland, Ohio, USA ; ; EP Services, California Pacific Medical Center, San Francisco, California, USA ; ; Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA.
authors: Andrea
authors: A
authors: Natale
keywords: Refractory atrial fibrillation (AF); catheter ablation; post-surgery arrhythmias; surgical ablation