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The complementary role of drug, ablation and device in the electrical therapy of atrial fibrillation

A. Capucci*, G.Q. Villani, N. Marrazzo and M. Piepoli

Divisione di Cardiologia, Ospedale Civile, Piacenza, Italy

* Correspondence: Alessandro Capucci, MD, Divisione di Cardiologia, Ospedale Civile, Via Taverna 49, 29100 Piacenza, Italy.

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia. Current therapies, including pharmacological treatment, radiofrequency ablation and implantable devices, showed significant limitation when used alone. Recently a number of combined therapies (hybrid therapy approach) were suggested. Radiofrequency ablation may improve the efficacy of drugs, pacing and automatic internal defibrillators. Antiarrhythmic drugs may play a similar role, enhancing preventive atrial pacing effectiveness as well as sinus rhythm restoration capabilities of cardioversion shocks and antitachycardia pacing. The availability of a wide range of therapeutic options suggests that the approach to the treatment of AF needs to be selected on an individual basis.

Key Words: Atrial fibrillation • antiarrhythmic drugs • atrial cardioversion • radiofrequency ablation • dual chamber pacing • implantable cardioverter-defibrillator

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