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Minimally invasive surgical ablation: Should we ablate harder or smarter?

  • David Callans
    Correspondence
    Address reprint requests and correspondence: Dr David Callans, Cardiac Electrophysiology, University of Pennsylvania Health System, 3400 Spruce St, Founders 9 Pavilion, Philadelphia, PA 19104.
    Affiliations
    Cardiac Electrophysiology Section, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Ramanan Kumareswaran
    Affiliations
    Cardiac Electrophysiology Section, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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      Despite continuing enhancement of our knowledge of many aspects of atrial fibrillation (AF), our understanding remains incomplete. AF causes significant reduction in quality of life because of AF and increases the risk of stroke.
      • Dorian P.
      • Jung W.
      • Newman D.
      • Paquette M.
      • Wood K.
      • Ayers G.M.
      • Camm J.
      • Akhtar M.
      The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy.
      Many patients still remain symptomatic despite adequate rate control and may benefit from rhythm control approach. The efficacy of antiarrhythmic drugs (AADs) is modest at best and carries a long list of side effects including proarrhythmia.
      • Jais P.
      • Cauchemez B.
      • Macle L.
      • et al.
      Catheter ablation versus antiarrhythmic drugs for atrial fibrillation the A4 study.
      This has led to many patients opting to undergo invasive procedures to improve their quality of life.
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