TY - JOUR
T1 - Catheter ablation of atrial arrhythmias
T2 - State of the art
AU - Lee, Geoffrey
AU - Sanders, Prashanthan
AU - Kalman, Jonathan M.
N1 - Funding Information:
GL is the recipient of a research scholarship from the National Health and Medical Research Council of Australia (NHMRC). JMK is the recipient of a grant from NHMRC (604908) .
Funding Information:
PS has served on the advisory board of Bard Electrophysiology, Biosense-Webster, Medtronic, St Jude Medical, Merck, and Sanofi-Aventis, and has received lecture fees or research funding from Bard Electrophysiology, Biosense-Webster, Medtronic, and St Jude Medical. JMK is the recipient of research funding and fellowship support from Medtronic, St Jude Medical, and Johnson & Johnson Medical. GL declares that he has no conflicts of interest.
PY - 2012/10
Y1 - 2012/10
N2 - Catheter ablation is at the forefront of the management of a range of atrial arrhythmias. In this Series paper, we discuss the underlying mechanisms and the current role of catheter ablation for the three most common atrial arrhythmias encountered in clinical practice: focal atrial tachycardia, atrial flutter, and atrial fibrillation. The mechanisms of focal atrial tachycardia and atrial flutter are well understood, and these arrhythmias are amenable to curative catheter ablation with high success rates. In most cases, paroxysmal atrial fibrillation is initiated by triggers located within pulmonary vein musculature. Circumferential ablation to isolate this musculature is associated with high success rates for elimination of paroxysmal atrial fibrillation in selected populations. Because of the problem of recurrent pulmonary vein connection, more than one procedure will be needed in about 30% of patients, and new technologies are being developed to reduce this occurrence. The mechanisms that sustain persistent atrial fibrillation are not well understood and are the subject of continuing investigation. As such, ablation approaches and technologies for this arrhythmia are still evolving.
AB - Catheter ablation is at the forefront of the management of a range of atrial arrhythmias. In this Series paper, we discuss the underlying mechanisms and the current role of catheter ablation for the three most common atrial arrhythmias encountered in clinical practice: focal atrial tachycardia, atrial flutter, and atrial fibrillation. The mechanisms of focal atrial tachycardia and atrial flutter are well understood, and these arrhythmias are amenable to curative catheter ablation with high success rates. In most cases, paroxysmal atrial fibrillation is initiated by triggers located within pulmonary vein musculature. Circumferential ablation to isolate this musculature is associated with high success rates for elimination of paroxysmal atrial fibrillation in selected populations. Because of the problem of recurrent pulmonary vein connection, more than one procedure will be needed in about 30% of patients, and new technologies are being developed to reduce this occurrence. The mechanisms that sustain persistent atrial fibrillation are not well understood and are the subject of continuing investigation. As such, ablation approaches and technologies for this arrhythmia are still evolving.
UR - http://www.scopus.com/inward/record.url?scp=84867798450&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(12)61463-9
DO - 10.1016/S0140-6736(12)61463-9
M3 - Review article
C2 - 23101718
AN - SCOPUS:84867798450
SN - 0140-6736
VL - 380
SP - 1509
EP - 1519
JO - The Lancet
JF - The Lancet
IS - 9852
ER -