Modern aspects of surgical treatment of patients with atrial fibrillation. Development of uniform criteria for selecting patients for radiofrequency ablation

• Main Authors: I. A. Libov, I. M. Mayorov, L. P. Porunov
• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2020-01-01
• Series: Медицинский совет
• Subjects: atrial fibrillation; radiofrequency ablation; patient selection criteria; multielectrode catheter; persistent form of af; high density mapping
• Online Access: https://www.med-sovet.pro/jour/article/view/5475

The article discusses the issues concerning the treatment of patients with the atrial fibrillation (AF), analyzes the indications for execution, in the absence of the effect of medication treatment, radiofrequency catheter ablation (RFA) of the lung vein entries and electrical spiral waves in the atria or rotors, the clinical effects of this procedure, assesses the contribution of focal activity in maintaining the persistent AF. The influence of concomitant pathology and anatomical-morphological peculiarities of the heart on early and distant RFA results in patients with persistent AF is discussed. The success and efficacy of AF surgical treatment depends not only on the method and technology of the chosen procedure, but also on the risk factors for the recurrence of AF (so-called predictors). Radio-frequency ablation, being an invasive surgery, has its own spectrum of possible complications and high economic component, which predetermines the necessity to predict the efficiency of the procedure, i.e. preoperative determination of the patient group, in which this type of treatment will be justified, and the expected efficiency and safety – higher than the probability of complications. The study of this problem and the development of criteria for selecting patients with AF will allow predicting the effectiveness of surgical intervention with high probability, which in turn will contribute to the correct strategy selection.