title: Hybrid therapy in the management of atrial fibrillation.
abstract: Atrial fibrillation is the most common sustained arrhythmia. Because of the sub-optimal outcomes and associated risks of medical therapy as well as the recent advances in non-pharmacologic strategies, a multitude of combined (hybrid) algorithms have been introduced that improve efficacy of standalone therapies while maintaining a high safety profile. Antiarrhythmic administration enhances success rate of electrical cardioversion. Catheter ablation of antiarrhythmic drug-induced typical atrial flutter may prevent recurrent atrial fibrillation. Through simple ablation in the right atrium, suppression of atrial fibrillation may be achieved in patients with previously ineffective antiarrhythmic therapy. Efficacy of complex catheter ablation in the left atrium is improved with antiarrhythmic drugs. Catheter ablation followed by permanent pacemaker implantation is an effective and safe treatment option for selected patients. Additional strategies include pacing therapies such as atrial pacing with permanent pacemakers, preventive pacing algorithms, and/or implantable dual-chamber defibrillators are available. Modern hybrid strategies combining both epicardial and endocardial approaches in order to create a complex set of radiofrequency lesions in the left atrium have demonstrated a high rate of success and warrant further research. Hybrid therapy for atrial fibrillation reviews history of development of non-pharmacological treatment strategies and outlines avenues of ongoing research in this field.
authors.forename: Zdenk
authors.initials: Z
authors.lastname: Starek
authors.forename: Frantisek
authors.initials: F
authors.lastname: Lehar
authors.forename: Jiri
authors.initials: J
authors.lastname: Jez
authors.forename: Jiri
authors.initials: J
authors.lastname: Wolf
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic. zdenek.starek@fnusa.cz.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Novák
mesh_terms: D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000628:therapy*; D001282:Atrial Flutter / Q000188:drug therapy; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D006801:Humans
chemical_list: D000889:Anti-Arrhythmia Agents