Heart rhythm : the official journal of the Heart Rhythm Society
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Review Meta Analysis
Pulmonary vein isolation with complex fractionated atrial electrogram ablation for paroxysmal and nonparoxysmal atrial fibrillation: A meta-analysis.
Pulmonary vein isolation (PVI) is recognized as a potentially curative treatment for atrial fibrillation (AF). Ablation of complex fractionated atrial electrograms (CFAEs) in addition to PVI has been advocated as a means to improve procedural outcomes, but the benefit remains unclear. ⋯ In these studies of patients with nonparoxysmal AF, addition of CFAE ablation to PVI results in greater improvement in freedom from AF. No additional benefit of this combined approach was observed in patients with paroxysmal AF.
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While the mechanism underlying the development of post-cardiothoracic surgery atrial fibrillation has not been fully elucidated, it has been suggested that inflammation may play a causative role. Corticosteroids have been traditionally used to reduce inflammation, and when administered perioperatively, they may decrease the incidence of atrial fibrillation. ⋯ Corticosteroids appear to reduce the incidence of post-cardiothoracic surgery atrial fibrillation and shorten hospital length of stay in randomized controlled trials.