Current status of catheter ablation for atrial fibrillation

摘要

Curative catheter ablation of atrial fibrillation has made some important advances during the last years toward a reproducible and effective procedure. Besides the role of the trigger to induce atrial fibrillation episodes by rapid burst from within the pulmonary veins (PVs), invasive electrophysiological studies could also demonstrate the importance of the close-by surrounding atrial myocardium to sustain atrial fibrillation. Meanwhile, new energies sources such as laser, ultrasound and cryothermia are used, next to the established ablation technology of radiofrequency current ablation, to apply lesions mostly around the PV ostia. With the magnetic navigation system, a new technology has entered the arena of catheter ablation of complex arrhythmia. By combining both three-dimensional mapping system and three-dimensional imaging ability, the system allows complete remote-controlled mapping (and ablation) of atrial fibrillation.