New Mechanism-based Approaches to Ablating Persistent AF: Will Drug Therapy Soon Be Obsolete?
Persistent atrial fibrillation (AF) represents a major public health and medical challenge. The progressive nature of the disease, high morbidity, and increasing health-economic costs ensure that it remains at the forefront of novel research into mechanisms and potential therapies. These are largely divided into pharmacological (drugs) and electrical (ablation) with patients often going from former to latter. AF ablation has improved sufficiently to be offered as first line for paroxysmal AF, but whether drug therapy will or be relegated. In this review, we shall outline the progress in mechanistic understanding of AF that may allow results from ablation to diverge dramatically from drug therapy and identify populations in whom drug therapy may become less relevant. We end by looking ahead to future developments that we hope will spur on therapeutic efficacy in both fields.
Department of Cardiovascular Medicine, Stanford Medicine, Stanford, CA.
Junaid A B
JA
Zaman
Tina
T
Baykaner
Sanjiv M
SM
Narayan
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000639:trends*; D006801:Humans; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents