TY - JOUR
T1 - A Randomized Study of Prophylactic Catheter Ablation in Asymptomatic Patients with the Wolff-Parkinson-White Syndrome
AU - Pappone, Carlo
AU - Santinelli, Vincenzo
AU - Manguso, Francesco
AU - Augello, Giuseppe
AU - Santinelli, Ornelia
AU - Vicedomini, Gabriele
AU - Gulletta, Simone
AU - Mazzone, Patrizio
AU - Tortoriello, Valter
AU - Pappone, Alessia
AU - Dicandia, Cosimo
AU - Rosanio, Salvatore
PY - 2003/11/6
Y1 - 2003/11/6
N2 - BACKGROUND: Young age and inducibility of atrioventricular reciprocating tachycardia or atrial fibrillation during invasive electrophysiological testing identify asymptomatic patients with a Wolff-Parkinson-White pattern on the electrocardiogram as being at high risk for arrhythmic events. We tested the hypothesis that prophylactic catheter ablation of accessory pathways would provide meaningful and durable benefits as compared with no treatment in such patients. METHODS: From 1997 to 2002, among 224 eligible asymptomatic patients with the Wolff-Parkinson-White syndrome, patients at high risk for arrhythmias were randomly assigned to radio-frequency catheter ablation of accessory pathways (37 patients) or no treatment (35 patients). The end point was the occurrence of arrhythmic events over a five-year follow-up period. RESULTS: Patients assigned to ablation had base-line characteristics that were similar to those of the controls. Two patients in the ablation group (5 percent) and 21 in the control group (60 percent) had arrhythmic events. One control patient had ventricular fibrillation as the presenting arrhythmia. The five-year Kaplan-Meier estimates of the incidence of arrhythmic events were 7 percent among patients who underwent ablation and 77 percent among the controls (P
AB - BACKGROUND: Young age and inducibility of atrioventricular reciprocating tachycardia or atrial fibrillation during invasive electrophysiological testing identify asymptomatic patients with a Wolff-Parkinson-White pattern on the electrocardiogram as being at high risk for arrhythmic events. We tested the hypothesis that prophylactic catheter ablation of accessory pathways would provide meaningful and durable benefits as compared with no treatment in such patients. METHODS: From 1997 to 2002, among 224 eligible asymptomatic patients with the Wolff-Parkinson-White syndrome, patients at high risk for arrhythmias were randomly assigned to radio-frequency catheter ablation of accessory pathways (37 patients) or no treatment (35 patients). The end point was the occurrence of arrhythmic events over a five-year follow-up period. RESULTS: Patients assigned to ablation had base-line characteristics that were similar to those of the controls. Two patients in the ablation group (5 percent) and 21 in the control group (60 percent) had arrhythmic events. One control patient had ventricular fibrillation as the presenting arrhythmia. The five-year Kaplan-Meier estimates of the incidence of arrhythmic events were 7 percent among patients who underwent ablation and 77 percent among the controls (P
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U2 - 10.1056/NEJMoa035345
DO - 10.1056/NEJMoa035345
M3 - Article
C2 - 14602878
AN - SCOPUS:0242348705
VL - 349
SP - 1803
EP - 1811
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 19
ER -