Atrial fibrillation is the most common cardiac arrhythmia seen in clinical practice, occurring in paroxysmal, persistent or permanent forms. New anti-arrhythmic agents are being trialled for the pharmacological treatment of affected patients. Catheter ablation is an effective therapeutic intervention for the treatment of patients with symptomatic, drug-refractory paroxysmal atrial fibrillation.
A correction for this article was published in the November 2012 issue of Medicine Today. The full text PDF of this article (see link above) has been corrected.
- The two main aims of treatment of patients with atrial fibrillation (AF) are symptom control and reduction in thromboembolic risk.
- Once AF has been diagnosed, either a rate control or rhythm control treatment strategy may be reasonable.
- Symptomatic patients often derive much greater symptom relief from rhythm control, which may be achieved pharmacologically or with electric cardioversion.
- The decision to opt for rate control is based on symptoms and likelihood of long-term sinus rhythm maintenance.
- In the small proportion of patients in whom rate control is difficult to achieve pharmacologically, permanent pacing followed by atrioventricular nodal ablation improves symptoms and quality of life.
- Catheter ablation is a highly efficacious strategy for maintaining sinus rhythm in patients with symptomatic paroxysmal AF who have failed one or more anti-arrhythmic drugs.