BACKGROUND: The aim of this prospective randomized study was to assess whether an early reablation was superior to antiarrhythmic drug (AAD) therapy in patients with previous failed pulmonary vein isolation. METHODS AND RESULTS:Patients with paroxysmal atrial fibrillation (AF) eligible for AAD therapy or reablation after a previously failed initial pulmonary vein isolation procedure were eligible for this study and were followed up for 3 years to assess rhythm by means of an implanted cardiac monitor. After the blanking period postablation, 154 patients had symptomatic AF recurrences and were randomized to AAD (n=77) or repulmonary vein isolation (n=77). At the end of follow-up, 61 (79%) patients in the AAD group and 19 (25%) patients in the reablation group demonstrated AF% progression (P<0.01). The AF% at 36 months was significantly greater in the AAD group compared with patients in the reablation group (18.8±11.4% versus 5.6±9.5%, respectively; P<0.01). In addition, 18 (23%) patients in the AAD group and 3 (4%) patients in the reablation group progressed to persistent AF (P<0.01). Furthermore, 45 (58%) of the 77 reablation group patients were free of AF/atrial tachycardia on no AADs; in contrast, in the AAD group, only 9 (12%) of the 77 patients were free of AF/atrial tachycardia (P<0.01) throughout follow-up. CONCLUSIONS:Redo AF ablation was substantially more effective than AAD in reducing the progression and prevalence of AF after the failure of an initial ablation. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01709682.
RCT Entities:
BACKGROUND: The aim of this prospective randomized study was to assess whether an early reablation was superior to antiarrhythmic drug (AAD) therapy in patients with previous failed pulmonary vein isolation. METHODS AND RESULTS:Patients with paroxysmal atrial fibrillation (AF) eligible for AAD therapy or reablation after a previously failed initial pulmonary vein isolation procedure were eligible for this study and were followed up for 3 years to assess rhythm by means of an implanted cardiac monitor. After the blanking period postablation, 154 patients had symptomatic AF recurrences and were randomized to AAD (n=77) or repulmonary vein isolation (n=77). At the end of follow-up, 61 (79%) patients in the AAD group and 19 (25%) patients in the reablation group demonstrated AF% progression (P<0.01). The AF% at 36 months was significantly greater in the AAD group compared with patients in the reablation group (18.8±11.4% versus 5.6±9.5%, respectively; P<0.01). In addition, 18 (23%) patients in the AAD group and 3 (4%) patients in the reablation group progressed to persistent AF (P<0.01). Furthermore, 45 (58%) of the 77 reablation group patients were free of AF/atrial tachycardia on no AADs; in contrast, in the AAD group, only 9 (12%) of the 77 patients were free of AF/atrial tachycardia (P<0.01) throughout follow-up. CONCLUSIONS: Redo AF ablation was substantially more effective than AAD in reducing the progression and prevalence of AF after the failure of an initial ablation. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01709682.
Authors: Robert K Altman; Riccardo Proietti; Conor D Barrett; Alessandro Paoletti Perini; Pasquale Santangeli; Stephan B Danik; Luigi Di Biase; Andrea Natale Journal: Ann Cardiothorac Surg Date: 2014-01
Authors: Luiz Pereira de Magalhães; Marcio Jansen de Oliveira Figueiredo; Fatima Dumas Cintra; Eduardo Benchimol Saad; Ricardo Ryoshim Kuniyoshi; Adalberto Menezes Lorga Filho; Andre Luiz Buchele D'Avila; Angelo Amato Vincenzo de Paola; Carlos Antonio Abunader Kalil; Dalmo Antonio Ribeiro Moreira; Dario Celestino Sobral Filho; Eduardo Back Sternick; Francisco Carlos da Costa Darrieux; Guilherme Fenelon; Gustavo Glotz de Lima; Jacob Atié; José Carlos Pachón Mateos; José Marcos Moreira; José Tarcísio Medeiros de Vasconcelos Journal: Arq Bras Cardiol Date: 2016-12 Impact factor: 2.000
Authors: Moussa C Mansour; Emily M Gillen; Audrey Garman; Sarah C Rosemas; Noreli Franco; Paul D Ziegler; Jesse M Pines Journal: Heart Rhythm O2 Date: 2022-01-07