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KMID : 1011920110120030017
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International Journal of Arrhythmia
2011 Volume.12 No. 3 p.17 ~ p.21
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Recent Atrial Fibrillation Guidelines and Catheter Ablation
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Kim Young-Hoon
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Abstract
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Three societies recently issued updated guidelines for the management of atrial fibrillation (AF): The European Society of Cardiology (ESC); a task force of 3 US societies, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), and the Heart Rhythm Society (HRS), and finally, the Canadian Cardiovascular Society (CCS). Since the last guidelines were issued in 2006, new outcome studies have added to the knowledge base and expanded the therapeutic horizons for rhythm control in AF. This renewed interest in AF is a reflection of the growing problem that this condition causes worldwide and the exciting new pharmaceutical developments demonstrated in recent clinical trials. The updated guidelines are aimed principally at introducing 1 new anti-arrhythmic drug, dronedarone, as the primary rhythm control option in various subsets of AF patients. In addition, catheter ablation has been deployed with the intention of ‘curing’ AF in several patient populations. For an individual patient with symptomatic AF, there must be sufficient potential benefit to justify a complex ablation procedure associated with potentially significant complications. For patients with either persistent AF or long-standing persistent AF, especially in asymptomatic patients, the treatment strategies and the benefit-risk ratio of catheter ablation are less well established. The highlights of the new guidelines are addressed and the role of catheter ablation for AF, based on ESC guidelines, is reviewed.
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KEYWORD
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atrial fibrillation, catheter ablation, dronedarone
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