?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Non-pharmacological+Treatment+of+Atrial+Fibrillation&rft.creator=Anfinsen%2C+Ole-Gunnar&rft.subject=Indian+Pacing+and+Electrophysiology+Journal&rft.description=In+selected+patients+with+atrial+fibrillation+and+severe+symptoms%2C+non-pharmacological+treatment+may+be+an+alternative+or+supplement+to+drug+therapy.+Atrioventricular+nodal+radiofrequency+ablation+(requires+pacemaker+implantation)%2C+or+atrial+pacing+for+sick+sinus+syndrome%2C+are+established+treatment+modalities.+All+other+non-pharmacological+therapies+for+atrial+fibrillation+are+still+experimental.+After+the+Maze+operation%2C+atrial+depolarization+has+to+follow+one+specific+path+determined+by+surgical+scars+in+the+myocardium.+This+prevents+new+episodes+of+atrial+fibrillation%2C+but+at+a+cost+of+perioperative+morbidity+and+mortality.+Catheter-based+%E2%80%9CMaze-like%E2%80%9D+radiofrequency+ablation+is+technically+difficult%2C+and+thrombo-embolic+complications+may+occur.+Paroxysmal+atrial+fibrillation+sometimes+is+initiated+by+spontaneous+depolarizations+in+a+pulmonary+vein+inlet.+Radio+frequency+ablation+against+such+focal+activity+has+been+reported+with+high+therapeutic+success%2C+but+the+results+await+confirmation+from+several+centres.+For+ventricular+rate+control%2C+most+electrophysiologists+present%C2%ADly+prefer+ablation+to+induce+a+complete+atrioventricular+conduction+block+(with+pacemaker)+rather+than+trying+to+modify+conduction+by+incomplete+block.+Atrial+or+dual+chamber+pacing+may+prevent+atrial+fibrillation+induced+by+bradycardia.+It+remains+to+confirm+that+biatrial+or+multisite+right+atrial+pacing+prevents+atrial+fibrillation+more+efficiently+than+ordinary+right+atrial+pacing.+An+atrial+defibrillator+is+able+to+diagnose+and+convert+atrial+fibrillation.+The+equipment+is+expensive%2C+and+therapy+without+sedation+may+be+unpleasant+beyond+tolerability.&rft.publisher=Indian+Pacing+and+Electrophysiology+Group&rft.contributor=Singh%2C+Balbir&rft.contributor=Lokhandwala%2C+Yash&rft.contributor=Francis%2C+Johnson&rft.contributor=Gupta%2C+Anup&rft.date=2002-01&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=text%2Fhtml&rft.identifier=http%3A%2F%2Fcogprints.org%2F4319%2F1%2Fanfinsen.htm&rft.identifier=++Anfinsen%2C+Ole-Gunnar++(2002)+Non-pharmacological+Treatment+of+Atrial+Fibrillation.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F4319%2F