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Related Experiment Videos

Device therapy for atrial fibrillation.

Lai Chow Kok1, Kenneth A Ellenbogen

  • 1Division of Cardiology, Department of Internal Medicine, Medical College of Virginia/Virginia Commonwealth University, 1101 East Marshal Street, Richmond, VA 23298, USA. laichow.kok@med.gov.va

Cardiology Clinics
|March 5, 2004
PubMed
Summary
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Device therapy offers options for atrial fibrillation (AF) patients. Careful selection of pacing sites and algorithms can reduce AF episodes, especially when curative treatments fail.

Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Numerous therapeutic options exist for patients experiencing recurrent symptomatic atrial fibrillation (AF).
  • Device therapy for AF shows promise but has not fully met management goals.
  • Atrial-based pacing is recommended for patients with sick sinus syndrome (SSS).

Purpose of the Study:

  • To evaluate the efficacy of different device therapies and pacing strategies in managing atrial fibrillation.
  • To explore the evolving role of radiofrequency ablation in AF management.
  • To determine the optimal use of pacemakers in AF patients who are not candidates for or have failed other procedures.

Main Methods:

  • Review of large randomized clinical trials and moderate-sized studies on device therapy for AF.

Related Experiment Videos

  • Analysis of data on multi-site pacing and alternative site pacing, including septal pacing.
  • Assessment of the current understanding of atrial tachycardia (AT) prevention and radiofrequency ablation techniques.

    • Main Results:

    • Atrial-based pacing is indicated for SSS patients.
    • Multi-site pacing shows minimal benefit in AF prevention, even with antiarrhythmic agents.
    • Alternative site pacing, like septal pacing, may offer similar AF reduction with less hardware.

    Conclusions:

    • Careful selection of pacing sites and algorithms is crucial for reducing AF episodes in patients with devices.
    • Radiofrequency ablation is an evolving treatment that may become more widely accepted.
    • Pacemaker therapy remains important for AF management, particularly for elderly patients or those unresponsive to other treatments.