Key result
Catheter ablation combined with antiarrhythmic drugs maintained sinus rhythm in 73.3% of patients with chronic AF, compared to 20% without AADs, and significantly decreased left atrial diameter.
Why the study?
Does a combination of catheter ablation and antiarrhythmic drugs improve maintenance of sinus rhythm and reverse structural changes in the left atrium in patients with chronic atrial fibrillation?
Does a combination of catheter ablation and antiarrhythmic drugs improve maintenance of sinus rhythm and reverse structural changes in the left atrium in patients with chronic atrial fibrillation?
An aggressive strategy combining catheter ablation and antiarrhythmic drugs effectively maintains sinus rhythm and promotes reverse structural remodeling of the left atrium in patients with chronic AF.
Hypothesis-generating for combined ablation and AADs in chronic AF; prospective trials needed before clinical adoption.
The effects of restoration and maintenance of sinus rhythm by a combination of catheter ablation and antiarrhythmic drugs (AADs) on atrial function in patients with chronic atrial fibrillation (AF) remain unknown. In 15 patients with chronic AF (>1 year), we attempted to restore and maintain sinus rhythm by ablation targeting complex fractionated atrial electrocardiograms (CFAEs) combined with pulmonary vein isolation with or without AADs. Sinus rhythm was restored in all patients. At 17:7 ± 7:2 months after AF ablation, maintenance of sinus rhythm was achieved in 20% of patients without AADs and in 73.3% of patients with AADs. The left atrial diameter decreased significantly by 9:5 ± 8:1% (P < 0:05) during the 12-month followup. AADs did not have any adverse effects. The aggressive strategy for maintenance of sinus rhythm involving AF ablation and AADs potentially led to recovery of structural changes in the LA in patients with chronic AF.
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Haruna et al. (2009) studied chronic atrial fibrillation (n=15). Catheter ablation and antiarrhythmic drugs vs. Catheter ablation without antiarrhythmic drugs was evaluated on maintenance of sinus rhythm. Catheter ablation combined with antiarrhythmic drugs maintained sinus rhythm in 73.3% of patients with chronic AF, compared to 20% without AADs, and significantly decreased left atrial diameter.
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