Key result
Hybrid therapies combining pharmacological and nonpharmacological modalities show increasing promise for subgroups of patients with atrial fibrillation.
Hybrid approaches combining antiarrhythmic drugs with nonpharmacological therapies such as catheter ablation or pacing show increasing promise for specific subgroups of patients with atrial fibrillation.
May support hybrid AF strategies in select subgroups; leaves open need for RCTs before practice change.
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and its prevalence continues to rise as the aged population increases. Comparative studies of rhythm control and rate control have been equivocal; however, the benefits of rhythm control may have been offset by the limitations of antiarrhythmic drugs. More recently, nonpharmacological therapies have emerged that provide hope of more effective rhythm control. Catheter ablation techniques have gained favour with high success rates in specialized centers, although these techniques are not without complications and require considerable expertise. Pacing therapies designed to reduce harmful right ventricular pacing and increase physiological pacing have shown benefit in AF patients with bradycardia. Despite this progress, no single modality confers benefit for all patients. Strategies to combine these treatment modalities in a hybrid approach has shown increasing promise for subgroups of AF patients.
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Govindan et al. (2008) conducted a review in Atrial fibrillation. Hybrid therapies (drugs supplementing nonpharmacological therapies) was evaluated. Hybrid therapies combining pharmacological and nonpharmacological modalities show increasing promise for subgroups of patients with atrial fibrillation.
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