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Abbildung 13: Ballonkatheter, CardioFocus, Inc., Marlborough, MA, USA: Nach Erleuchtung der Gewebeoberfläche über optische Fasern wird mit einer Laserdiode kontinuierlich Laserenergie appliziert, um eine zirkumferentielle Läsion um die Pulmonalveneneinmündungen zu erzeugen. (adaptiert von CardioFocus, Inc.)
Source publication
Catheter ablation for atrial fibrillation has become an accepted therapy. The arrhythmia affects around 6% of the population over the age of 65 years. Electrical isolation of the pulmonary veins from the left atrium is the central strategy in catheter ablation for paroxysmal atrial fibrillation. However, procedural outcomes and efficacy using seque...
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While atrial fibrillation (AF) begets AF via structural, contractile, and electrical remodeling, it was shown that successful radiofrequency ablation of AF has effectively reversed left atrial (LA) remodeling. However, there was little data regarding the efficacy of cryoablation on LA remodeling. Herein, we aimed to assess the impact of cryoablatio...
Citations
... All patients underwent wide-area circumferential pulmonary vein isolation for paroxysmal AF with additional linear lesions for persistent AF. The ablation was performed point by point by radiofrequency energy and guided by a threedimensional electroanatomical mapping system (Figure 2) [61]. The endpoint of the procedure in both paroxysmal and persistent AF patients was electrical isolation of all pulmonary veins, which was assessed using a circular spiral catheter. ...
Atrial fibrillation (AF) is the commonest of all sustained arrhythmias, and most of the patients seeking medical therapy are in the elderly age group. The management of these patients is particularly difficult due to associated comorbidities. Hypertension, congestive heart failure, left ventricular hypertrophy, and coronary artery disease are often present in the elderly patient population, and therefore, antiarrhythmic drugs often fail due to side effects, proarrhythmia, or poor rhythm control. Recently, radiofrequency catheter ablation has been widely performed as an efficient therapy for recurrent, drug-refractory AF. Nevertheless, patients at old age were underrepresented in prior AF ablation trials, and the current guidelines for catheter ablation of AF recommend a noninvasive approach in the elderly patient group due to the lack of clinical data supporting ablation therapy. However, study results of our group and others are suggesting that catheter ablation is a safe and effective treatment for patients over the age of 65 years with symptomatic, drug-refractory AF, and therefore, patients should not be precluded from catheter ablation only on the basis of age. This paper discusses the pharmacological (rhythm control, rate control, and anticoagulation) and catheter management of AF in the elderly population.
