NONPHARMACOLOGIC TREATMENT OF ATRIAL-FIBRILLATION - CURRENT AND EVOLVING STRATEGIES

Atrial fibrillation is the most common cardiac arrhythmia requiring tr eatment. Limitations of medical treatment have prompted development of nonpharmacologic therapies for this arrhythmia, These are aimed at ve ntricular rate control during atrial fibrillation, termination of the arrhythmia, and/or prevention of recurrences. Ventricular rate control can be achieved with transcatheter ablation or modification of the at rioventricular node. The MAZE operation is effective in preventing arr hythmia recurrence, but because it requires cardiac surgery, its appea l is limited. Development of the technique for direct transcatheter ab lation of atrial fibrillation is eagerly anticipated and may represent the standard curative treatment of the future. In appropriately selec ted patients, implantable device therapy may play an important role in the treatment of paroxysmal atrial fibrillation.