[Non-pharmacologic therapy of atrial fibrillation]

Since patients with recurrent atrial fibrillation are prone to recurrences, even under treatment with antiarrhythmic agents, alternative treatment modalities are being sought. Today, the non-pharmacological treatment modalities such as modification or ablation of the AV node or the operative procedures ("maze" or "corridor" operation) do not cure these patients. The non-pharmacological therapies are indicated if severe symptoms are due to high ventricular rate with hemodynamic compromise. In such cases, His bundle ablation followed by rate adaptive pacing can achieve control of symptoms in the majority of patients. In the future, more refined techniques for ablation or the introduction of automatic atrial cardioverters will extend therapeutic options.