Linked Life Data

8607391

Source:http://linkedlifedata.com/resource/pubmed/id/8607391

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
1996-5-23
pubmed:abstractText
Nonpharmacologic tools to treat atrial fibrillation (AF) are direct current cardioversion, radiofrequency (RF) current catheter ablation, antiarrhythmic surgery, pacing, and atrial defibrillation. In patients with sustained AF, when no cause can be found for AF or when the associated disease is mild, an attempt should be made to restore sinus rhythm. Electrical cardioversion by synchronized direct current shock can be attempted when drugs have failed and is the first choice in acutely ill patients. Virtually all patients should be anticoagulated. Temporary pacing should be available in patients with evidence of previous bradycardia. Although efficacy may be improved in patients pretreated with antiarrhythmic drugs, there is a considerable risk of adverse events. In AF and sinus node dysfunction, both pacing and antiarrhythmic drugs may be necessary. Pacing should be atrial or dual chamber, since ventricular pacing provokes AF. Failure to control the ventricular rate in AF can be treated by RF: atrioventricular (AV) node ablation, ablation of accessory pathways in preexcitation syndrome with AF, modulation of AV node, or ablation of AF. Antiarrhythmic surgery is a major procedure and may be the therapy of last resort in AF: the so-called corridor procedure isolates the fibrillating atria from a strip of tissue connecting the sinus and AV nodes. The maze procedure attempts to abolish AF by channeling the atrial activation between a series of incisions. In patients with chronic AF, internal cardioversion should be attempted if conventional transthoracic electrical cardioversion is ineffective. Several studies demonstrated the feasibility and efficacy of internal atrial defibrillation in selected patients with recent onset, as well as with chronic, AF. An implantable atrial defibrillator--as a stand-alone device or as part of a whole heart cardioverter--might be an option in the future. Nonpharmacologic tools play only a minor role in the management of paroxysmal and chronic AF. If symptoms persist despite pharmacologic therapy and other causes of persisting symptoms are excluded, consideration should be given to cardiac pacing, RF catheter treatment, or surgery. in some cases nonpharmacologic therapy of the AV node must be followed by implantation of a permanent pacemaker (due to complete AV block) and anticoagulation (due to persistence of underlying AF.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
25
pubmed:volume
77
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
45A-52A
pubmed:dateRevised
2005-11-16
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
Nonpharmacologic strategies for treating atrial fibrillation.
pubmed:affiliation
Department of Cardiology, University of Bonn, Germany.
pubmed:publicationType
Journal Article, Review