ABSTRACT
The incidence of atrial fibrillation (AF) in Brugada syndrome (BrS) has been reported at between 9% and 53% by different series, but the true prevalence is unknown. However, AF may be the presenting feature in some patients. The underlying mechanisms for AF may be a combination of multiple factors, genetic or acquired, that may impact upon autonomic function, atrial structure, and conduction velocities or other unknown factors. The presence of AF has been associated with a more malignant course, with a greater incidence of syncope and ventricular arrhythmias, thus acting as marker of more advanced disease. Regarding the management of patients with AF, antiarrhythmic drugs effective in preventing malignant arrhythmias in BrS such as quinidine or invasive treatment with pulmonary vein isolation (PVI) may be useful in AF treatment. In this review, we aim to present the current perspectives regarding the genetics, pathophysiology, management, and prognosis of AF in patients with BrS.
Subject(s)
Action Potentials , Atrial Fibrillation , Brugada Syndrome , Heart Conduction System , Heart Rate , Ablation Techniques , Action Potentials/drug effects , Anti-Arrhythmia Agents/therapeutic use , Atrial Fibrillation/diagnosis , Atrial Fibrillation/epidemiology , Atrial Fibrillation/physiopathology , Brugada Syndrome/diagnosis , Brugada Syndrome/epidemiology , Brugada Syndrome/physiopathology , Brugada Syndrome/therapy , Heart Conduction System/drug effects , Heart Conduction System/physiopathology , Heart Conduction System/surgery , Heart Rate/drug effects , Humans , Prevalence , Risk Factors , Treatment OutcomeABSTRACT
AF ablation can be curative or reduce the symptoms of AF. However, success rates are suboptimal while procedure times can be long. Since AF ablation depends on excellent tip to tissue contact, ease of use and signal quality, a new ablation catheter (FlexAbilityTM Ablation Catheter, St Jude Medical, St Paul, MN) was designed for use during complex ablation. We report an initial case of its use during paroxysmal AF.
ABSTRACT
Perimitral atrial flutter in cardiac allograft recipients is uncommon. In general, mitral isthmus ablation can be quite challenging in all patients with perimitral flutter, including the subset of patients who present following left atrial ablation for atrial fibrillation. We report 2 cases where an anterior ablation line was easily performed to eliminate perimitral flutter and produce bidirectional block.
