Key result
Pulmonary vein isolation is suggested for younger patients with fewer risk factors, while atrioventricular junction ablation with pacing is considered for older patients with comorbidities.
Rhythm control with PVI is preferred for younger patients with fewer risk factors, whereas rate control with AV junction ablation and pacing is suited for older patients with multiple comorbidities.
Supports tailored AF strategy selection by age and risk; leaves open randomized validation of PVI versus AVJ ablation.
<ns3:p>Atrial fibrillation is the most common reason for arrhythmic hospitalizations and one of the leading causes ofstroke. Recently we have been witnessing growing morbidity related to this arrhythmia, mostly in developedcountries. The therapeutic approach should incorporate both elimination and limitation of risk factors and tailoredpharmacologic and invasive treatment. There are two possible strategies for invasive management ofsymptomatic atrial fibrillation: rhythm control and heart rate control. The first strategy implies pulmonaryvein isolation (PVI) and it should be restricted to younger patients with fewer risk factors. The second strategy,which involves pacer implantation and atrioventricular junction ablation, may be considered in older patientswith numerous risk factors and comorbidities.</ns3:p>
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Bardyszewski et al. (2017) conducted a review in Atrial fibrillation. Pulmonary vein isolation and atrioventricular junction ablation was evaluated. Pulmonary vein isolation is suggested for younger patients with fewer risk factors, while atrioventricular junction ablation with pacing is considered for older patients with comorbidities.
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