Aktuelle Aspekte in der Therapie des Vorhofflimmerns – „Highlights“ der DGK-Jahrestagung 2015

Abstract

Atrial fibrillation (AF) is the most common arrhythmia prompting clinical presentation. Of the available pharmacologic and non-pharmacologic treatment options, the fastest growing and most intensely studied is catheter-based ablation therapy for AF. Pulmonary vein isolation is the cornerstone of catheter ablation of paroxysmal AF. Meanwhile, the optimal ablation strategy beyond PVI in peristent AF remains to be elucidated. Several ablation approaches targeting the morphological or/and the functional substrate of AF are currently under investigation. Planning and evaluation of these novel ablation strategies needs to be strictly controlled in clinical studies. The latter might be improved by using miniaturized, implantable event recorders for continuous heart rhythm monitoring.

• Literatur

• 1 McLellan AJ, Ling LH, Azzopardi S et al. A minimal or maximal ablation strategy to achieve pulmonary vein isolation for paroxysmal atrial fibrillation: a prospective multi-centre randomized controlled trial (the Minimax study). Eur Heart J 2015; ehv139. [Epub ahead of print]
• 2 Vogler J, Steven D, Sultan A et al. CatHeter Ablation of perSistEnd Atrial Fibrillation: Pulmonary Vein Isolation versus Defragmentation. The CHASE-AF Trial. Clin Res Cardiol 2015; 104 (Suppl. 01)
• 3 Rolf S, Kircher S, Arya A et al. Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol 2014; 7: 825-833 ; doi: DOI: 10.1161/CIRCEP.113.001251.
• 4 Kircher S, Arya A, Altmann D et al. Individualized versus standardized substrate modification for the treatment of symptomatic atrial fibrillation: A randomized trial. Clin Res Cardiol 2015; 104 (Suppl. 01)
• 5 Tilz RR, Lin T, Scholz L et al. Focal Impulse and Rotor Modulation for the Treatment of Atrial Fibrillation using the Novel 64-Electrode Basket Catheter: Nine Months Outcomes. Clin Res Cardiol 2015; 104 (Suppl. 01)
• 6 Kuklik P, Schäffer B, Hoffmann BA et al. Catheter ablation of persistent atrial fibrillation guided by electrogram dyssynchrony: acute and long term effect. Clin Res Cardiol 2015; 104 (Suppl. 01)
• 7 Arentz T, Lehrmann H, Sorrel J et al. Substrate based Ablation compared to Pulmonary Vein Isolation Alone in Patients with Persistent Atrial Fibrillation. Clin Res Cardiol 2015; 104 (Suppl. 01)
• 8 Zhang Y, Wang Z, Zhang Y et al. Efficacy of cardiac autonomic denervation for atrial fibrillation: a meta-analysis. J Cardiovasc Electrophysiol 2012; 23: 592-600 DOI: 10.1111/j.1540-8167.2011.02270.x.
• 9 Katritsis DG, Pokushalov E, Romanov A et al. Autonomic denervation added to pulmonary vein isolation for paroxysmal atrial fibrillation: a randomized clinical trial. J Am Coll Cardiol 2013; 62: 2318-2325 DOI: 10.1016/j.jacc.2013.06.053.
• 10 Bourier F, Bertoglio C, Hoermann J et al. Simulation of left atrial ejection fraction and left atrial contractility after different atrial fibrillation ablation approaches in a patient specific computational model. Clin Res Cardiol 2015; 104 (Suppl. 01)