TY - JOUR
T1 - Circumferential pulmonary-vein ablation for chronic atrial fibrillation
AU - Oral, Hakan
AU - Pappone, Carlo
AU - Chugh, Aman
AU - Good, Eric
AU - Bogun, Frank
AU - Pelosi, Frank
AU - Bates, Eric R.
AU - Lehmann, Michael H.
AU - Vicedomini, Gabriele
AU - Augello, Giuseppe
AU - Agricola, Eustachio
AU - Sala, Simone
AU - Santinelli, Vincenzo
AU - Morady, Fred
PY - 2006/3/2
Y1 - 2006/3/2
N2 - Background: We conducted a randomized, controlled trial of circumferential pulmonary-vein ablation for the treatment of chronic atrial fibrillation. Methods: A total of 146 patients with a mean (±SD) age of 57±9 years who had chronic atrial fibrillation were randomly assigned to receive amiodarone and undergo two cardioversions during the first three months alone (the control group) or in combination with circumferential pulmonary-vein ablation. Cardiac rhythm was assessed with daily telephonic transmissions for one year. The left atrial diameter and the severity of symptoms were assessed at 12 months. Results: Among the 77 patients assigned to undergo circumferential pulmonary-vein ablation, ablation was repeated because of recurrent atrial fibrillation in 26 percent of patients and atypical atrial flutter in 6 percent. An intention-to-treat analysis showed that 74 percent of patients in the ablation group and 58 percent of those in the control group were free of recurrent atrial fibrillation or flutter without antiarrhythmic-drug therapy at one year (P = 0.05). Among the 69 patients in the control group, 53 (77 percent) crossed over to undergo circumferential pulmonary-vein ablation for recurrent atrial fibrillation by one year and only 3 (4 percent) were in sinus rhythm without antiarrhythmic-drug therapy or ablation. There were significant decreases in the left atrial diameter (12±11 percent, P
AB - Background: We conducted a randomized, controlled trial of circumferential pulmonary-vein ablation for the treatment of chronic atrial fibrillation. Methods: A total of 146 patients with a mean (±SD) age of 57±9 years who had chronic atrial fibrillation were randomly assigned to receive amiodarone and undergo two cardioversions during the first three months alone (the control group) or in combination with circumferential pulmonary-vein ablation. Cardiac rhythm was assessed with daily telephonic transmissions for one year. The left atrial diameter and the severity of symptoms were assessed at 12 months. Results: Among the 77 patients assigned to undergo circumferential pulmonary-vein ablation, ablation was repeated because of recurrent atrial fibrillation in 26 percent of patients and atypical atrial flutter in 6 percent. An intention-to-treat analysis showed that 74 percent of patients in the ablation group and 58 percent of those in the control group were free of recurrent atrial fibrillation or flutter without antiarrhythmic-drug therapy at one year (P = 0.05). Among the 69 patients in the control group, 53 (77 percent) crossed over to undergo circumferential pulmonary-vein ablation for recurrent atrial fibrillation by one year and only 3 (4 percent) were in sinus rhythm without antiarrhythmic-drug therapy or ablation. There were significant decreases in the left atrial diameter (12±11 percent, P
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U2 - 10.1056/NEJMoa050955
DO - 10.1056/NEJMoa050955
M3 - Article
C2 - 16510747
AN - SCOPUS:33644604591
VL - 354
SP - 934
EP - 941
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 9
ER -