Where data were available , the relative benefits seen held true both after a single or multiple procedure(s ) .
For patients with persistent atrial fibrillation , CA achieves significantly greater freedom from recurrent atrial fibrillation compared with medical therapy .
BACKGROUND Catheter ablation ( CA ) is commonly performed for persistent atrial fibrillation , but few high- quality r and omized controlled trials ( RCTs ) exist , leading to funding restrictions being proposed in several countries .
We performed a r and om-effects meta- analysis of RCTs and non- RCTs to assess the efficacy of CA for persistent atrial fibrillation .
Usefulness of ablation of complex fractionated atrial electrograms using nifekalant in persistent atrial fibrillation.
BACKGROUND Additional ablation of complex fractionated atrial electrograms ( CFAE ) after pulmonary vein isolation ( PVI ) has been shown to improve the success of ablation of persistent atrial fibrillation ( AF ) . However , extensive ablation is often necessary to eliminate all CFAE or to terminate AF . We assessed the usefulness of the administration of an antiarrhythmic drug ( AAD ) before CFAE ablation . METHODS AND RESULTS One-hundred and ten patients with persistent AF first underwent PVI , roof and floor linear ablation ( box isolation ) . One hundred patients who remained in AF after box isolation were then r and omized to either receive ( AAD group , n=50 ) or not receive ( no-AAD group , n=50 ) intravenous nifekalant ( 0.3mg/kg ) followed by a CFAE ablation . In the AAD group , nifekalant terminated AF in 19 ( 38 % ) patients and ablation of localized CFAE was performed in 31 patients who remained in AF after nifekalant , and terminated AF in 11 ( 35 % ) patients . In the no-AAD group , ablation of CFAE terminated AF in 13 ( 26 % ) patients . The AAD group had a significantly lesser number of radio frequency applications at CFAE sites ( 18 ± 12 versus 36 ± 10 , p<0.0001 ) and shorter procedure time ( 162 ± 34 versus 197 ± 29 min , p<0.0001 ) compared with the no-AAD group . However , there was no significant difference in success rate at 12 months after a single ablation procedure between the two groups ( AAD group , 74 % versus no-AAD group , 76 % ) . CONCLUSIONS An approach to ablation using nifekalant may be useful in localizing areas of CFAE , reducing the number of applications at CFAE sites and procedure time . Ablation of only CFAE localized with nifekalant may be sufficient for clinical outcome
Where data were available , the relative benefits seen held true both after a single or multiple procedure(s ) .
For patients with persistent atrial fibrillation , CA achieves significantly greater freedom from recurrent atrial fibrillation compared with medical therapy .
BACKGROUND Catheter ablation ( CA ) is commonly performed for persistent atrial fibrillation , but few high- quality r and omized controlled trials ( RCTs ) exist , leading to funding restrictions being proposed in several countries .
We performed a r and om-effects meta- analysis of RCTs and non- RCTs to assess the efficacy of CA for persistent atrial fibrillation .