Pulmonary-vein isolation for atrial fibrillation in patients with heart failure

Mohammed N. Khan, Pierre Jaïs, Jennifer Cummings, Luigi Di Biase, Prashanthan Sanders, David O. Martin, Josef Kautzner, Steven Hao, Sakis Themistoclakis, Raffaele Fanelli, Domenico Potenza, Raimondo Massaro, Oussama Wazni, Robert Schweikert, Walid Saliba, Paul Wang, Amin Al-Ahmad, Salwa Beheiry, Pietro Santarelli, Randall C. StarlingAntonio Dello Russo, Gemma Pelargonio, Johannes Brachmann, Volker Schibgilla, Aldo Bonso, Michela Casella, Antonio Raviele, Michel Haïssaguerre, Andrea Natale

Research output: Contribution to journalArticlepeer-review


Background: Pulmonary-vein isolation is increasingly being used to treat atrial fibrillation in patients with heart failure. Methods: In this prospective, multicenter clinical trial, we randomly assigned patients with symptomatic, drug-resistant atrial fibrillation, an ejection fraction of 40% or less, and New York Heart Association class II or III heart failure to undergo either pulmonary-vein isolation or atrioventricular-node ablation with biventricular pacing. All patients completed the Minnesota Living with Heart Failure questionnaire (scores range from 0 to 105, with a higher score indicating a worse quality of life) and underwent echocardiography and a 6-minute walk test (the composite primary end point). Over a 6-month period, patients were monitored for both symptomatic and asymptomatic episodes of atrial fibrillation. Results: In all, 41 patients underwent pulmonary-vein isolation, and 40 underwent atrioventricular-node ablation with biventricular pacing; none were lost to follow-up at 6 months. The composite primary end point favored the group that underwent pulmonary-vein isolation, with an improved questionnaire score at 6 months (60, vs. 82 in the group that underwent atrioventricular-node ablation with biventricular pacing; P

Original languageEnglish
Pages (from-to)1778-1785
Number of pages8
JournalNew England Journal of Medicine
Issue number17
Publication statusPublished - Oct 23 2008

ASJC Scopus subject areas

  • Medicine(all)


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