ATRIAL FIBRILLATION CATHETER ABLLATION: YESTERDAY, TODAY, TOMORROW
In the present article we demonstrate data on epidemic nature of atrial fibrillation spread (AF) today, and describe economic and social consequences of abrupt increase in patient numbers. The strategy of AF treatment and significant restriction in opportunities of drug treatment is discussed. Intervention treatment was developed after discovery of pulmonary vein electric activity and its connection with induction and persisting arrhythmia. We described in details technique of catheter ablation in patients with paroxysmal and persisting atrial fibrillation. It is shown that despite a row of additional acceptances and approaches in catheter ablation, pulmonary vein isolation remains a cornerstone for AF successful treatment. Today there are two main approaches for catheter treatment: radio-frequency and cryoballoon isolation of pulmonary veins. Introduction of new modifications with a cryocylinder allows to reduce operation time and shorten complication development probability. Necessity for integrated approach to treat patients with persisting arrhythmia, further complications and possibility to develop new technologies is discussed. We consider team approach in treatment this category of patients to be extremely important.