How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients : Pulmonary Vein Isolation (and Beyond) - 20/12/17

Doi : 10.1016/j.hfc.2016.07.016

Carola Gianni, MD ^a,^b, Luigi Di Biase, MD, PhD, FHRS ^a,^c,^d,^e, Sanghamitra Mohanty, MD, MS ^a, Yalçın Gökoğlan, MD ^a, Mahmut Fatih Güneş, MD ^a, Amin Al-Ahmad, MD, FHRS, CCDS ^a, J. David Burkhardt, MD, FHRS ^a, Andrea Natale, MD, FESC, FHRS ^a,^f,^g,^h,^i,^j,^⁎
^a Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705, USA
^b Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
^c Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
^d Department of Biomedical Engineering, University of Texas, Austin, TX, USA
^e Department of Cardiology, University of Foggia, Foggia, Italy
^f MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
^g Division of Cardiology, Stanford University, Stanford, CA, USA
^h Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA
ⁱ Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA, USA
^j Dell Medical School, University of Texas, Austin, TX, USA

^∗Corresponding author. Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, 3000 North IH-35, Suite 700, Austin, TX 78705.

Résumé

Although cardiac resynchronization therapy (CRT) is an important treatment of symptomatic heart failure patients in sinus rhythm with low left ventricular ejection fraction and ventricular dyssynchrony, its role is not well defined in patients with atrial fibrillation (AF). CRT is not as effective in patients with AF because of inadequate biventricular capture and loss of atrioventricular synchrony. Both can be addressed with catheter ablation of AF. It is still unclear if these therapies offer additive benefits in patients with ventricular dyssynchrony. This article discusses the role and techniques of catheter ablation of AF in patients with heart failure, and its application in CRT recipients.

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Keywords : Catheter ablation, Atrial fibrillation, Heart failure, Cardiac resynchronization therapy, Pulmonary vein ablation, Triggers

Plan

Key points

Introduction

Atrial fibrillation and heart failure

Atrial fibrillation and cardiac resynchronization therapy

Studies on atrial fibrillation ablation in patients with heart failure

Ablation approach

Summary

	This article originally appeared in Cardiac Electrophysiology Clinics, Volume 7, Issue 4, December 2015.
	Disclosures: The authors have nothing to disclose and no conflict relevant to the subject matter or materials discussed in this article.

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Vol 13 - N° 1

P. 199-208 - janvier 2017 Retour au numéro

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How to Improve Cardiac Resynchronization Therapy Benefit in Atrial Fibrillation Patients : Pulmonary Vein Isolation (and Beyond) - 20/12/17

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