Author/Editor		Vokač, Damijan
Title		Nefarmakološki pristop k zdravljenju atrijske fibrilacije
Translated title		Non-pharmacological approach to treatment of atrial fibrillation
Type		članek
Source		In: Hojs R, Krajnc I, editors. Zbornik predavanj in praktikum 10. srečanje internistov in zdravnikov splošne medicine Iz prakse za prakso z mednarodno udeležbo; 1999 maj 21-22; Maribor. Maribor: Spošna bolnišnica Maribor,
Publication year		1999
Volume		str. 155-69
Language		slo
Abstract		Background Atrial fibrillation is the most frequent cardiac arrhythmia which is associated by a marked morbidity and mortality.The basic therapeutic approach to treatment is antiarhytmic drug therapy which is not usually effective or is associated with marked side effects. The absence of safe and effective drug therapy and enhanced development in understanding pathophysilogic basis of atrial fibrillation, have led to the development of novel nonpharmacologic approaches forthe management of this arrhythmia. Methods These treatments include surgical approaches known as corridor and maze procedure and catheter based cardiac ablation interventional approaches as are ablation and modification of AV conduction, catheter based ablation of atrial flutter and fibrillation and implantation of devices as are internal atrial defibrillator and biatrilal or bi-site atrial pacemakers. All of these techniques are potentially curative and offer long periods of sustained sinus rhythm and sparing of long term risks of site effects of standard anthyarrhithmic drug therapy. As the pathophysiologic knowledge of atrial fibrillation will further increase the technological innovations in mapping and radiofrequency ablation catheters will further facilitate identification and ablation of critical isthmuses and sites responsible for atrial fibrillation. These innovations will substantially improve success rate of ablation of atrial fibrillation. Conclusions Fortypical atrial flutterwhich in often triggering arrhythmia for atrial fibrillation catheter ablation success rate is already 80%. For patients with atrial fibrillation,AV junction ablation and modification remains palliative procedure. The maze procedure offers very high success rate, catheter based procedures simulating surgical maze are most promising and might be curative with nearly the same success rates as surgical in future. The implantable devices as automatic atrial defibrillator could offer to some patients acceptable therapy.
Descriptors		ATRIAL FIBRILLATION HEART CONDUCTION SYSTEM CATHETER ABLATION DEFIBRILLATORS, IMPLANTABLE