Until now antiarrhythmic drugs remain the first step in the treatment strategy for atrial fibrillation (AF), tachycardia (AT) and flutter (AFL). When successive drug failures or severe side effects of drugs emerge, selected patients can benefit from radiofrequency (RF) catheter ablative or surgical procedures.
1-9 For patients with conventional reasons for chronic cardiac pacing in whom also paroxysmal atrial tachyarrhythmias (PAT) prevail or other reasons exist to avoid invasive therapies for PAT, specific atrial pacing programmes delivered by implanted pacemakers can be switched on. Often pacing will be combined with antiarrhythmic drugs to treat PAT. In the foregoing, prevention or suppression of PAT is addressed. If immediate termination of PAT is the option, in-hospital DC cardioversion or emergency drug intervention is needed because the atrial defibrillator is currently not being used due to the patient’s discomfort and chest pain despite low-energy shocks.
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