Emanuele Bertaglia1, Gaetano Senatore2, Laura De Michieli3, Antonio De Simone4, Claudia Amellone2, Sonia Ferretto3, Vincenzo La Rocca4, Marco Giuggia2, Domenico Corrado3, Franco Zoppo5, Giuseppe Stabile6. 1. Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy; Ospedale Civile, via Mariutto, Mirano (VE), Italy. Electronic address: bertagliaferro@alice.it. 2. Ospedale Civile, via Battitore, Ciriè, Italy. 3. Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy. 4. Casa di Cura San Michele, Maddaloni (CE), Italy. 5. Ospedale Civile, via Mariutto, Mirano (VE), Italy. 6. Casa di Cura San Michele, Maddaloni (CE), Italy,; Clinica Mediterranea, via Orazio, Napoli, Italy.
Abstract
BACKGROUND: Randomized and controlled studies have reported the effect of catheter ablation (CA) for atrial fibrillation (AF) over a follow-up of 12-24 months. OBJECTIVE: We report on the effect of CA plus antiarrhythmic drugs in comparison with antiarrhythmic drugs alone on the maintenance of sinus rhythm over 12-year follow-up. METHODS: We extended the follow-up duration of the 137 patients who were enrolled in the Catheter Ablation for the Cure of Atrial Fibrillation Study between February 1, 2002, and June 30, 2003, and randomized toantiarrhythmic drugs (control group) or antiarrhythmic drugs plus CA (ablation group). The primary end point was time to first symptomatic or asymptomatic recurrence of atrial arrhythmia lasting >30 seconds during follow-up. RESULTS: During follow-up, 19 of 68 (27.9%; 95% confidence interval [CI] 18.7%-39.6%) ablation group patients and 3 of 69 (4.3%; 95% CI 1.49%-12.0%) control group patients did not experience any relapse of atrial tachyarrhythmia (P < .001). The Kaplan-Meier analysis performed to determine the probability of survival free from atrial arrhythmias showed a statistical difference in favor of the ablation group (log-rank, P < .001). The effect of CA was consistent in both patients with paroxysmal AF and those with persistent AF. In the multivariate Cox regression analysis, belonging to the control group (hazard ratio 2.95; 95% CI 1.896-4.726; P < .001) and longer time since first AF episode (hazard ratio 1.004; 95% CI 1.002-1.084; P = .041) were predictors of atrial tachyarrhythmia recurrence. CONCLUSION: In patients with paroxysmal and persistent AF, CA significantly increased time to first recurrence of atrial arrhythmias during 12-year follow-up.
RCT Entities:
BACKGROUND: Randomized and controlled studies have reported the effect of catheter ablation (CA) for atrial fibrillation (AF) over a follow-up of 12-24 months. OBJECTIVE: We report on the effect of CA plus antiarrhythmic drugs in comparison with antiarrhythmic drugs alone on the maintenance of sinus rhythm over 12-year follow-up. METHODS: We extended the follow-up duration of the 137 patients who were enrolled in the Catheter Ablation for the Cure of Atrial Fibrillation Study between February 1, 2002, and June 30, 2003, and randomized to antiarrhythmic drugs (control group) or antiarrhythmic drugs plus CA (ablation group). The primary end point was time to first symptomatic or asymptomatic recurrence of atrial arrhythmia lasting >30 seconds during follow-up. RESULTS: During follow-up, 19 of 68 (27.9%; 95% confidence interval [CI] 18.7%-39.6%) ablation group patients and 3 of 69 (4.3%; 95% CI 1.49%-12.0%) control group patients did not experience any relapse of atrial tachyarrhythmia (P < .001). The Kaplan-Meier analysis performed to determine the probability of survival free from atrial arrhythmias showed a statistical difference in favor of the ablation group (log-rank, P < .001). The effect of CA was consistent in both patients with paroxysmal AF and those with persistent AF. In the multivariate Cox regression analysis, belonging to the control group (hazard ratio 2.95; 95% CI 1.896-4.726; P < .001) and longer time since first AF episode (hazard ratio 1.004; 95% CI 1.002-1.084; P = .041) were predictors of atrial tachyarrhythmia recurrence. CONCLUSION: In patients with paroxysmal and persistent AF, CA significantly increased time to first recurrence of atrial arrhythmias during 12-year follow-up.
Authors: Youzheng Dong; Shucai Xiao; Jinwu He; Kaixin Shi; Si Chen; Deping Liu; Bin Huang; Zhenyu Zhai; Juxiang Li Journal: Front Cardiovasc Med Date: 2022-08-04
Authors: Lisa W M Leung; Ryan J Imhoff; Howard J Marshall; Diana Frame; Peter J Mallow; Laura Goldstein; Tom Wei; Maria Velleca; Hannah Taylor; Mark M Gallagher Journal: J Cardiovasc Electrophysiol Date: 2021-12-16 Impact factor: 2.942