New Insights On Ablation Of Persistent Atrial Fibrillation: Evidence From The SARA Trial.
نویسندگان
چکیده
Since Haissaguerre et al first described the pathogenic role of pulmonary vein firing as a crucial mechanism triggering atrial fibrillation, catheter ablation has been recommended as a curative treatment. Several trials have demonstrated that ablation is an effective treatment in most patients with paroxysmal atrial fibrillation and low-grade remodelled atria. In patients with persistent AF, there is substantially less evidence, mostly based on non-randomized studies, supporting this recommendation. The available scientific evidence as well as the current approaches to treating persistent AF patients are discussed in this article. Further, we describe the main findings of the SARA trial and put them into perspective.
منابع مشابه
Effects Of Fast Pathway Ablation On The Concealment Zone And Electrophysiological Behavior Of AV-Node During Atrial Fibrillation.
Objectives: Dual pathways have a determinant role in the occurrence of atrio nodal tachyarrhythmia (AVNRT). The aim of present study is to determine the role of slow pathway (SP) in the concealment zone and protective role of AV node during atrial fibrillation (AF). Material &Methods: In 7 isolated nodal rabbit preparation zone of concealment and concealed conduction is quantified by Specif...
متن کاملHeart Failure, Atrial Fibrillation, and Catheter Ablation
Contemporary cardiological practice places great emphasis on the availability of an evidence base to justify and refine indications for treatment. This is particularly apposite to the field of catheter ablation for atrial fibrillation (AF), where almost 2 decades of research at an increasingly frenetic pace has delivered us a potentially curative treatment in carefully selected patients. In dru...
متن کاملStaged transthoracic approach to persistent atrial fibrillation (TOP-AF): study protocol for a randomized trial
BACKGROUND Persistent atrial fibrillation frequently shows multiple different electrophysiological mechanisms of induction. This heterogeneity causes a low success rate of single procedures of ablation and a high incidence of recurrence. Surgical ablation through bilateral thoracotomy demonstrates better results after a single procedure. Prospective observational studies in inhomogeneous popula...
متن کاملMoving catheter ablation forward from paroxysmal to persistent atrial fibrillation: progress, limitations, and surprises of the SARA trial
Over the past decade, eight randomized studies have compared the efficacy of catheter ablation and antiarrhythmic drug therapy for rhythm control in patients with atrial fibrillation (AF). Most studies investigated patients with paroxysmal AF after failure of one or more antiarrhythmic drug. All studies showed superiority of catheter ablation over antiarrhythmic drug treatment with respect to r...
متن کاملCryoablation in persistent atrial fibrillation – a critical appraisal
Ablation of atrial fibrillation is an established treatment for the management of patients with paroxysmal and persistent atrial fibrillation. The complex pathophysiology of persistent atrial fibrillation has fuelled the concept of adjunctive substrate modification on top of pulmonary vein isolation. However, recent studies have failed to demonstrate additive benefit from complex ablation appro...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of atrial fibrillation
دوره 7 2 شماره
صفحات -
تاریخ انتشار 2014