1. Amiodarone in refractory atrial fibrillation. Amiodarone is a powerful drug that often allows you to maintain sinus rhythm or at least control the frequency of ventricular contractions in the presence of persistent AF, when other means are ineffective.
However, due to its many undesirable effects, amiodarone should be prescribed only to patients for whom other drugs have been ineffective, or those at risk of side effects in the long term is not the main criterion for the choice of treatment due to poor prognosis, i.e. the elderly and / or those with severe organic myocardial damage.
2. Catheter ablation in refractory atrial fibrillation. To prevent recurrence of paroxysmal AF, as well as in some cases, persistent AF, transvenous catheter ablation is increasingly being used by applying radio frequency energy to various areas of myocardial LP.
This method of treatment is described in a separate article on the site (we recommend using the search form on the main page of the site). Sometimes ablation is performed surgically, usually simultaneously with another surgery.
In the presence of severe clinical symptoms in case of ineffectiveness or intolerance to antiarrhythmic drugs, another method of treatment is the RFA of the AV compound. The procedure involves the simultaneous implantation of a permanent EX and continued use of anticoagulants, but it allows you to very effectively control the symptoms and, as was shown in a number of studies, improves the quality of life of patients and eliminates the need to continue antiarrhythmic therapy.