[Resistant atrial fibrillation: how far does one go in its treatment?]

Resistant atrial fibrillation consists in recurrent or persistent fibrillation despite a conventional treatment persistent. When conventional treatments (drugs, external defibrillation) fails, we have the following options: internal defibrillation, pacemaker implantation either standard or with biatrial pacing, curative or palliative radiofrequency ablation techniques, antiarrhythmic surgery, atrial defibrillator implantation. These different treatment modalities, isolated or combined will frequently be able to reduce the patient symptoms and some of at them may suppress the majority of atrial fibrillation episodes. Not all these treatments are widely used at the present time but a lot of research is being done about them. The purpose of this article is to describe their use in resistant patients.