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Hybrid therapy of atrial fibrillation: algorithms and outcome
Journal article   Peer reviewed

Hybrid therapy of atrial fibrillation: algorithms and outcome

Sanjeev Saksena and Nandini Madan
Journal of interventional cardiac electrophysiology, v 9(2), pp 235-247
01 Oct 2003
PMID: 14574037

Abstract

Algorithms Anti-Arrhythmia Agents - therapeutic use Atrial Fibrillation - epidemiology Atrial Fibrillation - physiopathology Atrial Fibrillation - therapy Atrial Function - physiology Catheter Ablation Combined Modality Therapy Defibrillators, Implantable Electric Countershock Heart Conduction System - physiopathology Heart Conduction System - surgery Humans Risk Factors Treatment Outcome
Rhythm control methods have not shown superior outcomes to rate control strategies in atrial fibrillation. Newer approaches to rhythm control employ "hybrid" therapies combining pharmacologic and non pharmacologic interventions. Pathophysiologic insights into mechanisms of atrial fibrillation (AF) suggest that arrhythmogenesis is due to interactions of multiple triggering rhythms and a complex electrophysiologic substrate resulting in the emergence of multiple tachyarrhythmias, often in disparate locations that may coexist in time. Thus, an "hybrid" therapy prescription is more likely to address several of the etiologic factors culminating in clinical AF. Results of pilot clinical studies of hybrid therapy are encouraging and involve drugs, devices and ablation techniques in varying permutations. Hybrid therapy algorithms using right heart procedures can improve efficacy with potentially lower risk. Considerations in implementation of these algorithms include staged or simultaneous interventions and a right versus left heart strategy. The parallel with the current coronary disease management paradigm is obvious and relevant.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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