We observed statistically significantly better AT recurrence-free survival with CPVA than with ADT .
BACKGROUND Circumferential pulmonary vein ablation ( CPVA ) has become common therapy for atrial fibrillation ( AF ) , but results of large r and omized controlled trials comparing this procedure with antiarrhythmic drug therapy ( ADT ) have not been published to date .
We conducted a systematic literature review to assess whether CPVA is superior to ADT for the management of AF .
Response to flecainide infusion predicts long-term success of hybrid pharmacologic and ablation therapy in patients with atrial fibrillation.
OBJECTIVES We tested the hypothesis that the response to flecainide infusion can identify patients with atrial fibrillation ( AF ) in whom the hybrid pharmacologic and ablation therapy reduces the recurrences of AF . BACKGROUND Infusion of class IC anti-arrhythmic drugs may promote transformation of AF into atrial flutter . Catheter ablation of atrial flutter has been demonstrated to be highly effective in preventing recurrences of atrial flutter . METHODS Seventy-one consecutive patients with paroxysmal or chronic AF , in whom flecainide infusion ( 2 mg/kg body weight , intravenously ) determined the transformation of AF into common atrial flutter ( positive response ) , were r and omized to receive one of the following treatments : oral pharmacologic treatment with flecainide ( group A , n = 23 ) ; the hybrid treatment ( catheter ablation of the inferior vena cava-tricuspid annulus isthmus , plus oral flecainide ) ( group B , n = 24 ) ; or catheter ablation of the isthmus only ( group C , n = 24 ) . Thirty-seven patients with a negative response to flecainide , who chose to be su bmi tted to the hybrid treatment , were selected as the control group ( group D ) . RESULTS During a mean follow-up period of 24 + /- 7.2 months , the recurrences of AF and atrial flutter in group B ( 42 % ) were significantly lower than those in group A ( 78 % , p < 0.001 ) , group C ( 92 % , p < 0.001 ) and group D ( 92 % , p < 0.001 ) . CONCLUSIONS The creation of a complete bi-directional conduction block at the inferior vena cava-tricuspid annulus isthmus , plus flecainide administration , reduces the recurrences of both AF and atrial flutter in patients with class IC atrial flutter . Moreover , the early response to flecainide is safe and reliable in identifying patients who may benefit from this therapy
We observed statistically significantly better AT recurrence-free survival with CPVA than with ADT .
BACKGROUND Circumferential pulmonary vein ablation ( CPVA ) has become common therapy for atrial fibrillation ( AF ) , but results of large r and omized controlled trials comparing this procedure with antiarrhythmic drug therapy ( ADT ) have not been published to date .
We conducted a systematic literature review to assess whether CPVA is superior to ADT for the management of AF .