ОК. Можно ли попросить вас прокоментировать тогда вот эту выдержку из гайда ACC/AHA 2006 года (ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation), на который я ссылался выше:
Цитата:
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8.1 Pharmacological and Nonpharmacological Therapeutic Options. Drugs and ablation are effective for both rate and rhythm control, and in special circumstances surgery may be the preferred option. Regardless of the approach, the need for anticoagulation is based on stroke risk and not on whether sinus rhythm is maintained. For rhythm control, drugs are typically the first choice and LA ablation is a second-line choice, especially in patients with symptomatic lone AF. In some patients, especially young ones with very symptomatic AF who need sinus rhythm, radiofrequency ablation may be preferred over years of drug therapy. Patients with pre-operative AF undergoing cardiac surgery face a unique opportunity. While few patients are candidates for a stand-alone surgical procedure to cure AF using the maze or LA ablation techniques, these approaches can be an effective adjunct to coronary bypass or valve repair surgery to prevent recurrent postoperative AF. Applied in this way, AF may be eliminated without significant additional risk. Because the LAA is the site of over 95% of detected thrombi, this structure should be removed from the circulation when possible during cardiac surgery in patients at risk of developing postoperative AF, although this has not been proved to prevent stroke (328).
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Имеются принципиальные различия тактики при фибрилляции и трепетании или подходы изменились ?