6 курс / Кардиология / И_А_Овсыщер_Ведение_больных_после_РЧИ_УЛВ
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Guglin M, et al. Sinus rhythm is associated with fewer heart failure symptoms: Insights from the AFFIRM trial. Heart Rhythm 2010;7:596.
Heart Rhythm 2010;7, Issue 5, May, P. 602.
Adam Zivin, MD
Measuring success in atrial fibrillation: Groping the elephant
―In the case of AF, we take it to be self-evident that SR—as nature intended—is the answer, but like the parable
of the blind men and the elephant, choosing and integrating observations into a coherent proof remains elusive.‖
Estimated Relationship Between FU Strategy and
the Rate of AF Detection
Figure 2. Estimated correlation between follow-up strategy and the rate of atrial fibrillation detection after RF ablation. Arya A, et al. PACE 2007;30:458.
Risk of Thromboembolic Events After Percutaneous Left
Atrial Radiofrequency Ablation of Atrial Fibrillation
Hakan Oral, Aman Chugh, Mehmet O¨ zaydın, Eric Good, Jackie Fortino, Sundar
Sankaran, Scott Reich, Petar Igic, Darryl Elmouchi, David Tschopp, Alan Wimmer, Sujoya Dey, Thomas Crawford, Frank Pelosi, Jr, Krit Jongnarangsin, Frank Bogun, and Fred Morady
Conclusions—The risk of a TE after LARFA is 1.1%, with most events occurring within 2 weeks after the procedure.
Discontinuation of anticoagulant therapy appears to be safe after successful LARFA, both in patients without risk factors for stroke and in patients with risk factors other than age 65 years and history of stroke. Sufficient safety data are as yet unavailable to support discontinuation of anticoagulation in patients older than 65 years or with a history of stroke.
(Circulation. 2006;114:759-765.)
Performed AF ablation guided by complex fractionated atrial electrogram (CFAE) mapping in 674 high-risk AF patients. The clinical end points were sinus rhythm (SR), death, stroke, or bleeding. The patients were relatively old (mean age 67±12 years) and 129 had EF 40%. If the patient remained in SR 3 months after the ablation, warfarin was then discontinued.
Conclusions. CFAE-targeted ablation of AF is effective in maintaining SR in selected high-risk AF patients and might allow patients to stop warfarin therapy.