[Non-pharmacologic treatment of atrial fibrillation].

Curative non pharmacological treatment of AF includes MAZA anti arrhythmic surgery and ist different variants which are reserved to AF associated with mitral valve disease. Radiofrequency (RF) ablation of AF creating lesions mimicking the MAZE procedure is another curative treatment but its numerous complications lead to put it in stand-by. Focal AF radiofrequency ablation is the only curative method that has encouraging results. The development of the internal cardioversion led to the development of the implantable atrial defibrillator. In spite of the low energy used, the internal shocks are often painful and not well tolerated conducting to stop the use of these devices. Prophylactic atrial pacing among patients with interatrial conduction delay is well established by dual site pacing pioneers. After several attempts to restore sinus rhythm and the fail of drug therapy to reduce heart rate, the latest solution to prevent tachycardiomyopathy is the atrio-ventricular (AV) node modulation or ablation using RF energy.