Effective treatment of fibrillation
Atrial Fibrillation
Why to do RFA of atrial fibrillation
Radicality
- RFA allows to restore and maintain sinus rhythm with further withdrawal of antiarrhythmic therapy (three months after RFA), and for people younger than 70 years it allows stop hypocoagulation treatment)
Effectiveness:
- more than 90% of patients have sinus rhythm recover during the first RFA procedure.
• 10% of patients require repeated intervention within 3-4 months after the initial session of RFA.
• 65% of patients have sinus rhythm persisted 5 years after the intervention.
• the number of strokes, heart attacks and progression of CHF is reliably reduced
Safety:
- RFA is safe for patients of any age, incl. age group of older than 65 years, including those suffering from chronic somatic pathology, CHF, who were denied treatment by RFA in other centers.
What patients with atrial fibrillation are to be advised rfa of atrial fibrillation?
Patients with paroxysmal, persistent and chronic forms of AF, regardless of the duration of arrhythmia, atrial size, age
What patients with atrial fibrillation do not need RFA?
- Patients with clots in the left atrium
• Patients with unstable course of IHD
• Patients with congenital and acquired valvular heart disease, requiring surgical correction
How to prepare PATIENTS WITH ATRIAL FIBRILLATION to RFA?
At least one month prior to the scheduled RFA surgery patients with atrial fibrillation should be put on the following medication:
— anticoagulants (warfarin, elicus, xarelto, pradaxa)
— antiarrhythmic drug (better class III drugs (cordarone in most cases), including patients with a chronic arrhythmia.
How to manage patients after RFA of atrial FIBRILLATION?
All patients continue to take antiarrhythmic drugs and anticoagulants for at least 3 months after RFA.
After an RFA in an acute period (the first 3 months), patients may experience episodes of atrial flutter / atrial fibrillation / atrial tachycardia. In this case, the treatment should be aimed at the prompt restoration of the sinus rhythm (the administration of additional doses of antiarrhythmic drugs and / or the performance of electrical cardioversion)
3 months after the RFA, a decision on further tactics of managing the patient (repeated RFA, antiarrhythmic drugs withdrawal) is to be taken
After 6 months, a decision on the possibility of anticoagulants withdrawal is to be taken
Typical atrial flutter
what patients with TYPICAL ATRIAL FLUTTER are to be advised RFA of TYPICAL ATRIAL FLUTTER?
Patients with paroxysmal, persistent and chronic forms of typical atrial flutter, regardless of the duration of arrhythmia, atrial size, age
what patients with TYPICAL ATRIAL FLUTTER do not need rfaRFA
- Patients with clots in the left atrium
• Patients with unstable course of IHD
• Patients with an active inflammatory process in the myocardium
• First 6 months after a stroke
how to prepare PATIENTS WITH TYPICAL ATRIAL FLUTTER to rfa?
At least one month prior to the scheduled RFA surgery patients with typical atrial flutter should be put on the following medication:
— anticoagulants (warfarin, elicus, xarelto, pradaxa)
it is necessary to cancel the following in 5 half-lives:
— all antiarrhythmic drugs
how to manage patients after rfa of TYPICAL ATRIAL FLUTTER?
All patients continue to take anticoagulants for at least 3 months after RFA.
SUPRAVENTRICULAR arrhythmia (AV nodal reentrant tachycardia, ORTHODROMATIC AND ANTIDROMIC TACHIACARDIA IN PATIENTS WITH WPW SYNDROME, atrial tachycardia)
What patients are to be advised rfa of TYPICAL ATRIAL FLUTTER?
All patients with supraventricular tachycardias are to have RFA provided that the conditions noted below are excluded
what patients with SVT do not need rfa?
- Patients with clots in the left atrium
• Patients with unstable course of IHD
• Patients with an active inflammatory process in the myocardium
• First 6 months after a stroke
• Pregnant (RFA is only life-saving surgery)
HOW TO PREPARE PATIENTS WITH SVT TO RFA?
At least one month prior to the scheduled RFA surgery patients with SVT should do a 5 half-lives withdrawal of all antiarrhythmic drugs
how to manage patients after rfa of svt?
Limitations of intensive physical activity for 1 month.
Control ECG every 3 months for 1 year
Antiarrhythmic drugs are not to be prescribed.