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2001, Number S1

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Arch Cardiol Mex 2001; 71 (S1)

Fibrilación atrial

Colín LLJ
Full text How to cite this article

Language: Spanish
References: 6
Page: 36-39
PDF size: 43.28 Kb.


Key words:

Atrial fibrillation, Treatment, Ablation.

ABSTRACT

Atrial fibrillation (AF) is the most common sustained arrhythmia. AF has now been exhaustively studied: more is known about its mechanism and research is moving towards new forms of treatment. For chronic AF, basically the control of ventricular rate and the brain protection are the main issues. It is well known that with the identification of high risk group for embolism, oral anticoagulation should be administered. Ventricular rate control can be achieved by using betablockers or calcium channel blockers, unless these are contraindicated for the elderly. Oral anticoagulation prevents the stroke. The main mechanism of AF is the re-entry of multiple wavelets, but now it is more frequently found on patients with focal AF. Therapies are employed to bring the patient to a sinusal rhythm as soon as possible with antiarrythmics or electric cardioversion externally or internally. The internal procedure includes 1 to 15 J and the success rate is of 91% vs 67% in relation to the external one. The introduction of the catheter ablation has opened new frontiers for the treatment of AF, first as the ablate-and-pace technique and now trying to mimic the maze procedure or with the ablation of the focal tachycardia. The stimulation for prevention of AF under research, as well as the implantable disfibrillation for selected patients. On going studies will show the possible benefit of this type of benefits.


REFERENCES

  1. ALLESIE MA, KONINGS K, KIRCHHOF CJ, WIJFFELS M: Electrophysiologic mechanisms of perpetuation of atrial fibrillation. Am J Cardiol 1996; 25(77): 10A-23A. Review.

  2. AUSMA J, WIJFFELS M, VAN EYS G, KOIDE M, RAMAEKERS F, ALLESIE M, ET AL: Dedifferentiation of atrial cardiomyocites as a result of chronic atrial fibrillation. Am J Pathol 1997; 151(4): 985-997.

  3. HAISAGUERRE M, JAIS P, SHAH DC, TAKAHASHI A, HOCINI M, QUINIOU G, ET AL. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998; 339: 659-666.

  4. FALK RH, POLLAK A, SINGH S N, FRIEDRICH T: Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. Intravenous dofetilide investigators. J Am Coll Cardiol 1997; 29: 385-390.

  5. SAKSENA S, PRAKASH A HILL M, KROL RB, MUNSIF AN, MATHEW PP, ET AL: Prevention of recurrent atrial fibrillation with chronic dualsite atrial pacing. J Am Coll Cardiol 1996; 228: 687-694.

  6. GEPSTEIN L, HAYAM HAYAM G, BEN HAIM SA: A novel method for nonfluoroscopic catheter- based electroanatomical mapping of the heart. In vivo and in vitro accuracy results. Circulation 1997; 95: 1611-1622.




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C?MO CITAR (Vancouver)

Arch Cardiol Mex. 2001;71