Hybrid Therapy in the Management of Atrial Fibrillation
Atrial fibrillation is the most common sustained arrhythmia. Because of the sub-optimal outcomes and associated
risks of medical therapy as well as the recent advances in non-pharmacologic strategies, a multitude of combined
(hybrid) algorithms have been introduced that improve efficacy of standalone therapies while maintaining a high safety
profile. Antiarrhythmic administration enhances success rate of electrical cardioversion. Catheter ablation of antiarrhythmic
drug-induced typical atrial flutter may prevent recurrent atrial fibrillation. Through simple ablation in the right atrium,
suppression of atrial fibrillation may be achieved in patients with previously ineffective antiarrhythmic therapy. Efficacy
of complex catheter ablation in the left atrium is improved with antiarrhythmic drugs. Catheter ablation followed by permanent
pacemaker implantation is an effective and safe treatment option for selected patients. Additional strategies include
pacing therapies such as atrial pacing with permanent pacemakers, preventive pacing algorithms, and/or implantable
dual-chamber defibrillators are available. Modern hybrid strategies combining both epicardial and endocardial approaches
in order to create a complex set of radiofrequency lesions in the left atrium have demonstrated a high rate of success and
warrant further research. Hybrid therapy for atrial fibrillation reviews history of development of non-pharmacological
treatment strategies and outlines avenues of ongoing research in this field.
Keywords: Atrial fibrillation, catheter ablation of arrhythmias, pharmacological antiarrhythmic therapy, hybrid therapy.
Rights & PermissionsPrintExport