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|Dr. Duane Pinto and Dr. Mark Josephson Discuss the Risks and Benefits of AF Ablation in the Josephson EP Report
Dr. Pinto and Dr. Josephson discuss the advantages of ablation as a treatment of atrial
fibrillation against other pharmacologic techniques. The increase in use of
catheter-based ablation for atrial fibrillation arises from the acknowledgement of the
seriousness of the condition and the lack of pharmacologic alternatives to treat it.
Dr. Josephson describes the evolution of the ablation, illustrating the technique as the
isolation of a focus firing in a pulmonary vein which causes atrial fibrillation.
technique is most effective among patients with paroxysmal atrial fibrillation to produce
an optimal risk/benefit ratio. In this population, the most effective procedure
demonstrates a bidirectional block, rather than an entrance block, as an endpoint.
Ultimately, positive procedural results mean better outcomes, and long-term outcomes are
best measured by monitoring.
Dr. Josephson compares the effectiveness of ablation to
amiodarone, an antiarrhythmic agent, stating that the 73% success rate at 1.5 years of
ablation is superior to the drug's benefits and side effects. Still, the development of
less toxic, atrio-specific drugs is promising.
KEYWORDS: Atrial fibrillation; ablation;
paroxysmal; electrophysiologic endpoint; amiodarone; entrance block; bidirectional block;
pulmonary foci; tachycardia; heart failure; stroke; dyssynchrony; tachymyopathy; Dr. Duane
Pinto; Dr. Mark Josephson.
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