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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Atrial fibrillation ablation strategies for paroxysmal patients randomized comparison between different techniques
Circulation: Arrhythmia and Electrophysiology, Volume 2, No. 2, Year 2009
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Description
Background-Whether different ablation strategies affect paroxysmal atrial fibrillation (AF) long-term freedom from AF/atrial tachyarrhythmia is unclear. We sought to compare the effect of 3 different ablation approaches on the long-term success in patients with paroxysmal AF. Methods and Results-One hundred three consecutive patients with paroxysmal AF scheduled for ablation and presenting in the electrophysiology laboratory in AF were selected for this study. Patients were randomized to pulmonary vein antrum isolation (PVAI; n=35) versus biatrial ablation of the complex fractionated atrial electrograms (CFAEs; n=34) versus PVAI followed by CFAEs (n=34). Patients were given event recorders and followed up at 3, 6, 9, 12, and 15 months postablation. There was no statistical significant difference between the groups in term of sex, age, AF duration, left atrial size, and ejection fraction. At 1 year follow-up, freedom from AF/atrial tachyarrhythmia was documented in 89% of patients in the PVAI group, 91% in the PVAI plus CFAEs group, and 23% in the CFAEs group (P<0.001) after a single procedure and with antiarrhythmic drugs. Conclusion-No difference in terms of success rate was seen between PVAI alone and PVAI associated with defragmentation. CFAEs ablation alone had the smallest impact on AF recurrences at 1-year follow-up. These results suggest that antral isolation is sufficient to treat most patients with paroxysmal AF. (Circ Arrhythmia Electrophysiol. 2009;2:113-119.) © 2009 American Heart Association, Inc.
Authors & Co-Authors
Elayi, Claude Samy
United States, Lexington
Uk Healthcare
Fahmy, Tamer S.
Italy, Mestre
Ospedale Umberto i, Mestre
Egypt, Cairo
Faculty of Medicine
Martin, David
United States, Cleveland
Cleveland Clinic Foundation
Ching, Chi Keong
Singapore, Singapore City
National Heart Centre Singapore
Barrett, Conor
United States, Boston
Massachusetts General Hospital
Bai, Rong
China, Wuhan
Huazhong University of Science and Technology
Patel, Dimpi
United States, Austin
St. David's Medical Center
Khaykin, Yaariv
Canada, Newmarket
Southlake Regional Health Centre
Hongo, Richard
United States, San Francisco
Sutter Pacific Heart Centers
Hao, Steven
United States, San Francisco
Sutter Pacific Heart Centers
Beheiry, Salwa
United States, San Francisco
Sutter Pacific Heart Centers
Pelargonio, Gemma
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Dello Russo, Antonio
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Casella, Michela
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Santarelli, Pietro
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Potenza, Domenico Rosario
Italy, San Giovanni Rotondo
Irccs Casa Sollievo Della Sofferenza
Fanelli, Raffaele
Italy, San Giovanni Rotondo
Irccs Casa Sollievo Della Sofferenza
Massaro, Raimondo
Italy, San Giovanni Rotondo
Irccs Casa Sollievo Della Sofferenza
Wang, Paul
United States, Palo Alto
Stanford University
Al-Ahmad, Amin
United States, Palo Alto
Stanford University
Arruda, Mauricio
United States, Cleveland
Case School of Medicine
Themistoclakis, Sakis
Italy, Mestre
Ospedale Umberto i, Mestre
Bonso, Aldo
Italy, Mestre
Ospedale Umberto i, Mestre
Rossillo, Antonio
Italy, Mestre
Ospedale Umberto i, Mestre
Raviele, Antonio
Italy, Mestre
Ospedale Umberto i, Mestre
Schweikert, Robert A.
United States, Akron
Akron General Hospital
Burkhardt, David J.
United States, Austin
St. David's Medical Center
Natale, Andrea
United States, Austin
St. David's Medical Center
United States, Palo Alto
Stanford University
United States, Cleveland
Case School of Medicine
Di Biase, Luigi
United States, Austin
St. David's Medical Center
Italy, Foggia
Università Degli Studi Di Foggia
Statistics
Citations: 137
Authors: 29
Affiliations: 16
Identifiers
Doi:
10.1161/CIRCEP.108.798447
ISSN:
19413149
e-ISSN:
19413084
Study Design
Cohort Study