As CABANA waves a final good bye to catheters in AF . . . let the pulmonary veins rejoice !
There is a tough ongoing rivalry between drugs and catheters to conquer the commonest electrical chaos in human heart, namely Atrial fibrillation (AF). Mind you,the confusion about the importance of this arrhythmia is huge and real.Bulk of these episodes are transient , paroxysmal and do not require rigorous management.While stroke prevention seems to be the major aim and target , the real world scenario seems to tell a different story.
The nomenclature conundrum
AF may be classified as many ways a learned cardiologists can think . Often it’s done with reference to etiology, duration , rate, neural (sympathetic or parasympathetic) humoral , cardiac or non cardiac , reversible or irreversible ( Endocrine, Electrolytic, hypoxia etc).
Unlike VT , bifurcating AF with reference to the presence or absence of structural heart disease is rarely meaningful.Subclinical atrial interstitial fibrosis in elderly is so common especially so in hypertensive individuals making all lone atrial fibrillation as true structural disease.
Classifying AF with reference to atrial enlargement again is problematic as any sustained AF can dilate these thin atrial chambers in few weeks time making it a sequel to AF rather than a cause to it.
Adding further fuel to the confusion is the recent man-made (read cardiac scientists!) problem .Linking the etiology of AF with the presence or absence of valves pathology is definitely not helping us. In the process , we forget a casual fact tha...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ACC AHA ESC guidelines for AF affirm race cabana amiodarone for atrial fibrillation CABANA trial carto pulmonary vein ablations cryo balloon for af ablation heart rhythm society atrial fibrillation guidelines rate vs rhythm c Source Type: blogs
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