Catheter Ablation of Atrial Fibrillation

American Heart Association: July 10, 2012.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with significant morbidity and cost.¹ AF is seen across a wide spectrum of patients, from lone AF without structural heart disease, to the postoperative setting, to patients with significant left ventricular dysfunction and advanced heart failure. AF is clinically classified as paroxysmal (<7 days), persistent (>7 days or requiring intervention to restore sinus rhythm), longstanding persistent (>1 year), or permanent, when restoration of sinus rhythm is no longer pursued.²

The presence of AF is associated with increased mortality, and treatment of patients requires symptom relief and prevention of thromboembolism. Optimal antithrombotic therapy is determined on the basis of stroke risk as predicted by the CHADS₂ scoring system (a system that awards 1 point each for congestive heart failure, hypertension, age ≥75 years, and diabetes mellitus and 2 points for prior stroke or transient ischemic attack).^3,4 More recently, a modified scoring system, CHA₂DS-VASC₂, has been shown to improve risk prediction for patients previously thought to be at low risk for thromboembolic events. Read more