Kohei Sawasaki

By Kohei Sawasaki

Various treatment methods have been used for atrial fibrillation (AF), which has long been a cause of cerebral infarction and heart failure. Antiarrhythmic drug, the first developed treatment, was not effective in maintaining sinus rhythm and did not improve prognosis. In contrast, pulmonary vein (PV) isolation is effective in paroxysmal AF, expected to maintain sinus rhythm by 70–80% in the first session. Therefore, catheter ablation is the first-line treatment for patients with drug-resistant paroxysmal AF. For PV isolation, radiofrequency ablation was developed first, followed by cryoballoon ablation, which was shown to be not inferior to radiofrequency ablation. In contrast, for persistent AF, PV isolation alone has been found to result in a low rate of maintenance of sinus rhythm. However, there has been no impact of the additional radiofrequency application on AF recurrence rate. Recently, a number of the predictive factors of AF recurrence after AF ablation have been reported. Among them, AF duration, defibrillation threshold, left atrial volume are considered useful as predictors of atrial fibrillation recurrence after ablation. In order to improve the outcome of AF ablation, it is desirable to select patients with AF in consideration of the predictive factors of AF recurrence after AF ablation.

Part of the book: Atrial Fibrillation