Key result
Hybrid therapy with isthmus catheter ablation and oral flecainide maintained freedom from atrial fibrillation and flutter in 53% of patients over a mean follow-up of 54.1 months.
Why the study?
Does inferior vena cava-tricuspid annulus isthmus catheter ablation and oral flecainide improve freedom from AF and AFL in patients with paroxysmal or persistent AF who develop AFL during flecainide infusion?
Cohort (n=154)
Does inferior vena cava-tricuspid annulus isthmus catheter ablation and oral flecainide improve freedom from AF and AFL in patients with paroxysmal or persistent AF who develop AFL during flecainide infusion?
Hybrid therapy with CTI ablation and oral flecainide provides long-term efficacy in maintaining sinus rhythm for patients with AF who develop AFL during flecainide infusion, particularly those with persistent AF or prior spontaneous AFL.
Answers are grounded in this paper and cite their sources.
May support hybrid therapy in AF patients developing AFL on flecainide; hypothesis-generating and requires randomized confirmation.
The flecainide infusion test has been proposed to screen candidates for hybrid pharmacological and ablation therapy. We report the long-term follow-up of 154 consecutive patients with paroxysmal or persistent atrial fibrillation (AF) who developed atrial flutter (AFL) during flecainide infusion (IC AFL), treated with inferior vena cava-tricuspid annulus isthmus catheter ablation and oral flecainide (hybrid therapy). Over a mean of 54.1 +/- 13.1 months 82 patients (53%) remained free of AF and AFL. Flecainide was discontinued because of adverse effects in 6 patients (4%). A history of persistent AF, and the documentation of >/=1 spontaneous AFL episode before the flecainide test were independent predictors of successful hybrid therapy. In patients with paroxysmal AF without documented spontaneous AFL, the long-term efficacy of hybrid therapy was 38.5% (P = 0.03). The flecainide infusion test reliably detects candidates for hybrid therapy. The efficacy of this therapy is maintained over the long-term with a high patient compliance.
No takes yet. Share an insight, caveat, or question.
Turco et al. (2005) conducted a cohort in Atrial fibrillation (n=154). Hybrid therapy (inferior vena cava-tricuspid annulus isthmus catheter ablation and oral flecainide) was evaluated on Freedom from AF and AFL. Hybrid therapy with isthmus catheter ablation and oral flecainide maintained freedom from atrial fibrillation and flutter in 53% of patients over a mean follow-up of 54.1 months.
Synapse has enriched 10 related papers. Consider them for comparative context: