ABSTRACT
Atrial fibrillation (AF) is the most frequent persistent cardiac arrhythmia and is associated with an increased mortality. Therefore, an effective differential treatment of patients is mandatory. After a risk stratification oral anticoagulation (OAC) should be initiated depending on the individual stroke risk of each patient. Alternatively, in the presence of contraindications for OAC and an increased risk for bleeding and/or stroke, the implantation of a left atrial appendage closure device can be considered. Symptomatic patients should undergo a rhythm control strategy if possible. Based on the risk-benefit considerations, catheter ablation (CA) of AF plays an increasingly important role in establishing long-term medicinal rhythm control. A pulmonary vein isolation can lead to freedom from AF for 1 year in 70-80% of patients with paroxysmal AF (and approximately 50% in persistent AF). So far, a survival advantage of CA could only be shown in patients with heart failure, so that in most cases this is only a symptomatic treatment for improvement in the quality of life.
Subject(s)
Atrial Appendage , Atrial Fibrillation , Catheter Ablation , Pulmonary Veins , Atrial Appendage/surgery , Atrial Fibrillation/drug therapy , Atrial Fibrillation/surgery , Humans , Quality of Life , Treatment OutcomeABSTRACT
The endoscopic laser balloon ablation system affords a unique view of the beating heart for visual guidance in pulmonary vein (PV) isolation. A 66-year-old patient was admitted for catheter ablation of atrial fibrillation (AF). While encircling the left superior PV, AF terminated into sinus rhythm, which was diagnosed by observing sudden regularization of previously rapidly fibrillating atrial tissue demonstrating the unique endoscopic video function.