Re: Ten Things Your Electrophysiologist Will Not Tell You About Lone Atrial Fibrillation

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Posted by L. Paul Teague on July 01, 2004 at 23:15:10:

In Reply to: Re: Ten Things Your Electrophysiologist Will Not Tell You About Lone Atrial Fibrillation posted by hutch on July 01, 2004 at 21:39:32:

Hutch: For some AF patients, PVI is now the procedure of choice. But only for a limited few.

The PVs can be a trigger for the initiation of AF. Isolation of the PVs can block this trigger for paroxysmal lone AF. It is of no value for chronic AF because the atria are already fibrillating. Part of the Maze procedure includes isolation of the PVs.

For most lone AF patients, PVI alone does not cure AF. But where the PVs are the trigger, it can work.

Catheter based procedures are trying to create lesions on the outside of the heart with access only to the inside of the heart; something that is inherently diffiult to do effectively.

Most unsuccesful catheter based results are not published so it is difficult to get accurate information for an informed decision. A number of failed catheter based procedures have had to be surgically repaired.

It is important to go for evaluation to a facility that does both surgical and catheter procedures. These multi discipline facilities can recommend the best option. A facility that does only catheter procedures is going to recommend what they do.

At least one facility [Cleveland Clinic] is doing a surgical procedure without stopping the heart. Lesions are created with RF or cryo probes.

Thanks for your comments.

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