[Invasive electrophysiology: complications, nightmares and their management]

[Atrial fibrillation ablation: who comes into consideration?]

Atrial fibrillation ablation is, since the introduction of the guidelines in 2006 and which were updated in 2007, now a standard procedure in many electrophysiological centers. Pulmonary vein isolation has proven itself as a way to eliminate focal triggers. From pathophysiological studies of atrial fibrillation development, it is known that ablation performed early in paroxysmal atrial fibrillation has the highest chance for success. In patients with persistent or permanent atrial fibrillation, success rates are lower and repeat interventions are needed more often. Therefore, continuation of antiarrhythmic drug therapy is often necessary in these patient groups. Thus, the curative use of ablation for atrial fibrillation is only possible with the current techniques for patients with paroxysmal atrial fibrillation.

[Catheter ablation of typical atrial flutter]

Atrial flutter is one of the most common supraventricular arrhythmic diseases and occurs with an incidence of 88/100,000. The high risk for thromboembolic events is similar to that for atrial fibrillation and also has the risk for fast conduction to the ventricle. Pharmacological treatment is not significantly effective. Catheter ablation of common atrial flutter offers an alternative with a high quality outcome ranging from 90-96% and a low recurrence rate of 2-6%. Radiofrequency catheter ablation of the cavotricuspidal isthmus is an established treatment for common atrial flutter. Modern techniques like cryo-ablation show nearly the same results and will be an alternative to the RF ablation in the future.