Cargando…

Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs

Atrial fibrillation (AF) is often treated with antiarrhythmic drugs (AADs) or catheter ablation. In a unique subset of patients, AF can convert to atrial flutter (AFL) after the initiation of an AAD. It has previously been shown that, in this subset of patients, cavotricuspid isthmus (CTI) ablation...

Descripción completa

Detalles Bibliográficos
Autores principales: Riad, Fady S., Waldo, Albert L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MediaSphere Medical 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252707/
https://www.ncbi.nlm.nih.gov/pubmed/32477703
http://dx.doi.org/10.19102/icrm.2019.101005
_version_ 1783539201134821376
author Riad, Fady S.
Waldo, Albert L.
author_facet Riad, Fady S.
Waldo, Albert L.
author_sort Riad, Fady S.
collection PubMed
description Atrial fibrillation (AF) is often treated with antiarrhythmic drugs (AADs) or catheter ablation. In a unique subset of patients, AF can convert to atrial flutter (AFL) after the initiation of an AAD. It has previously been shown that, in this subset of patients, cavotricuspid isthmus (CTI) ablation followed by the continuation of the AAD regimen has an unusually high rate of successfully maintaining sinus rhythm. This is an underrecognized approach toward rhythm management in such patients. However, the reason(s) for such a high degree of efficacy with this hybrid therapeutic approach are unclear. We suggest that conversion from AF to AFL selects for a group of patients in whom AF is particularly responsive to the effects of the AAD. Since CTI ablation is essentially curative of AFL, the combination of both techniques results in a high efficacy of sinus rhythm maintenance. Further investigation is required to confirm these hypotheses.
format Online
Article
Text
id pubmed-7252707
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MediaSphere Medical
record_format MEDLINE/PubMed
spelling pubmed-72527072020-05-28 Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs Riad, Fady S. Waldo, Albert L. J Innov Card Rhythm Manag Research Review Atrial fibrillation (AF) is often treated with antiarrhythmic drugs (AADs) or catheter ablation. In a unique subset of patients, AF can convert to atrial flutter (AFL) after the initiation of an AAD. It has previously been shown that, in this subset of patients, cavotricuspid isthmus (CTI) ablation followed by the continuation of the AAD regimen has an unusually high rate of successfully maintaining sinus rhythm. This is an underrecognized approach toward rhythm management in such patients. However, the reason(s) for such a high degree of efficacy with this hybrid therapeutic approach are unclear. We suggest that conversion from AF to AFL selects for a group of patients in whom AF is particularly responsive to the effects of the AAD. Since CTI ablation is essentially curative of AFL, the combination of both techniques results in a high efficacy of sinus rhythm maintenance. Further investigation is required to confirm these hypotheses. MediaSphere Medical 2019-10-15 /pmc/articles/PMC7252707/ /pubmed/32477703 http://dx.doi.org/10.19102/icrm.2019.101005 Text en Copyright: © 2019 Innovations in Cardiac Rhythm Management http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Review
Riad, Fady S.
Waldo, Albert L.
Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title_full Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title_fullStr Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title_full_unstemmed Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title_short Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs
title_sort revisiting an underrecognized strategy for rhythm management: hybrid therapy for patients who convert from atrial fibrillation to flutter on antiarrhythmic drugs
topic Research Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252707/
https://www.ncbi.nlm.nih.gov/pubmed/32477703
http://dx.doi.org/10.19102/icrm.2019.101005
work_keys_str_mv AT riadfadys revisitinganunderrecognizedstrategyforrhythmmanagementhybridtherapyforpatientswhoconvertfromatrialfibrillationtoflutteronantiarrhythmicdrugs
AT waldoalbertl revisitinganunderrecognizedstrategyforrhythmmanagementhybridtherapyforpatientswhoconvertfromatrialfibrillationtoflutteronantiarrhythmicdrugs