scholarly journals Report of a study group on ablate and pace therapy for paroxysmal atrial fibrillation

EP Europace ◽  
1999 ◽  
Vol 1 (1) ◽  
pp. 8-13 ◽  
Author(s):  
M. Brignole ◽  
M. Gammage ◽  
L. Jordaens ◽  
R. Sutton
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Pacemaker Implantation ◽  
Class I ◽  
Mode Switching ◽  
Complete Agreement ◽  
Study Group ◽  
Class Iii ◽  
Technical Features ◽  
Few Data

Abstract Atrioventricular junctional (AVJ) catheter ablation followed by pacemaker implantation is now widely accepted for patients affected by paroxysmal atrial fibrillation (PAF) not controlled by antiarrhythmic drugs. However, few data exist on its indications, optimal methodology and complications. Therefore a study group examined current practice in Europe and North America, using a questionnaire, followed by a Study Group Meeting to discuss the results. Based upon this, class I, class II and class III indications were proposed. Class I indications (for which general agreement existed) include drug-refractory PAF, correlating with important symptoms, the bradycardia–tachycardia syndrome already treated with a pacemaker, and continued PAF. Large differences exist in the current methodology, but consensus was reached on the technical approaches of right and left-sided AVJ ablation, and on the timing of pacemaker implant in relation to ablation. No complete agreement was reached on technical features such as catheter choice and heparin use. The recommended pacing mode was DDDR with mode switching.

scholarly journals Prospective, randomized study of atrioventricular ablation and mode-switching, dual chamber pacemaker implantation versus medical therapy in drug-resistant paroxysmal atrial fibrillation

EP Europace ◽  
1999 ◽  
Vol 1 (1) ◽  
pp. 15-19 ◽  
Author(s):  
M. Brignole ◽  
L. Gianfranchi ◽  
C. Menozzi ◽  
P. Alboni ◽  
G. Musso ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Drugs ◽  
Randomized Study ◽  
Pacemaker Implantation ◽  
Mode Switching ◽  
Clinical Effects ◽  
Dual Chamber Pacemaker

Abstract We performed a prospective randomized 6-month evaluation of the clinical effects of atrioventricular junctional ablation together with placement of a DDDR mode-switching pacemaker vs pharmacological treatment in 43 patients with intolerable paroxysmal atrial fibrillation not controlled with antiarrhythmic drugs. Ablation and pacemaker treatment were highly effective and superior to drug therapy in controlling symptoms and improving quality of life. However, discontinuation of drug therapy exposed patients to further recurrences of paroxysmal atrial fibrillation and the risk of developing permanent atrial fibrillation.

Long-term results of thoracoscopic ablation of paroxysmal atrial fibrillation: is the glass half full or half empty?

2021 ◽  
Author(s):  
Igor Belluschi ◽  
Elisabetta Lapenna ◽  
Davide Carino ◽  
Cinzia Trumello ◽  
Manuela Cireddu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Ventricular ◽  
Class I ◽  
Long Term Results ◽  
Left Ventricular Ejection ◽  
Af Recurrence

Abstract OBJECTIVES Previous series showed the outcomes of thoracoscopic ablation of stand-alone symptomatic paroxysmal atrial fibrillation (AF) for up to 7 years of follow-up. The goal of this study was to assess the long-term durability of surgical pulmonary vein isolation (PVI) beyond 7 years. METHODS Fifty consecutive patients {mean age 55 [standard deviation (SD): 11.2] years, previous catheter ablation in 56%, left ventricular ejection fraction 60% (SD: 4.6), left atrium volume 65 ml (SD: 17)} with stand-alone symptomatic paroxysmal AF underwent PVI through bilateral thoracoscopy ablation between 2005 and 2014. The CHA2DS2-VASc score was ≥2 in 12 patients (24%). RESULTS No hospital deaths occurred. At hospital discharge all patients but 1 (2%) were in sinus rhythm (SR). Follow-up was 100% complete [mean 8.4 years (SD: 2.3), max 15]. The 8-year cumulative incidence function of AF recurrence, with death as a competing risk, on or off class I/III antiarrhythmic drugs (AADs)/electrocardioversion/re-transcatheter ablation (TCA) was 20% (SD: 5; 95% confidence interval: 10, 32); and off class I/III AADs/electrocardioversion/re-TCA was 52% (SD: 7; 95% confidence interval: 0.83, 8.02). At 8 years, the predicted prevalence of patients in SR was 87% and 53% were off class I/III AADs/electrocardioversion/re-TCA. The recurrent arrhythmia was AF in all patients except 2, who had atypical atrial flutter (4%). No predictors of AF recurrence were identified. At the last follow-up, 76% of the patients showed European Heart Rhythm Association class I. No strokes or thromboembolic events were documented and 76% of the subjects were off anticoagulation therapy. CONCLUSIONS Despite a considerable AF recurrence rate, our single-centre, long-term outcome of surgical PVI showed encouraging data, with the majority of patients remaining in SR, although many of them were on antiarrhythmic therapy.

scholarly journals Clinical Efficacy of Bepridil for Class I Antiarrhythmic Drug-Induced Atrial Flutter in Patients with Paroxysmal Atrial Fibrillation

2008 ◽  
Vol 24 (2) ◽  
pp. 71-75
Author(s):  
Hidemori Hayashi ◽  
Masataka Sumiyoshi ◽  
Satoru Suwa ◽  
Hidehiko Sakurai ◽  
Yasunobu Kawano ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Clinical Efficacy ◽  
Antiarrhythmic Drug ◽  
Paroxysmal Atrial Fibrillation ◽  
Class I ◽  
Drug Induced ◽  
Class I Antiarrhythmic Drug

Inhibition of IK,ACh current may contribute to clinical efficacy of class I and class III antiarrhythmic drugs in patients with atrial fibrillation

2009 ◽  
Vol 381 (3) ◽  
pp. 251-259 ◽  
Author(s):  
Niels Voigt ◽  
Nadiia Rozmaritsa ◽  
Anne Trausch ◽  
Thomasz Zimniak ◽  
Torsten Christ ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Efficacy ◽  
Antiarrhythmic Drugs ◽  
Class I ◽  
Class Iii

553 Efficiency of new class III antiarrhythmic — Nibentan versus amiodarone for sinus rhythm restoration in paroxysmal atrial fibrillation patients

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 121-121
Author(s):  
A. Ardashev ◽  
M. Kruchko ◽  
O. Vrublevskiy ◽  
A. Shavarov ◽  
M. Chernov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Class Iii ◽  
New Class

Abstract 9733: Atrial Fibrosis is Associated With Higher DC Cardioversion Failure Rates in Persistent Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mohamed R Labedi ◽  
Abdulmohsin Ahmadjee ◽  
Mathias Koopman ◽  
Nassir Marrouche ◽  
Brent Wilson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Use ◽  
Sinus Rhythm ◽  
Univariate Analysis ◽  
Persistent Atrial Fibrillation ◽  
Class I ◽  
Class Iii ◽  
Atrial Fibrosis ◽  
Dc Cardioversion

Introduction: DC cardioversion (DCCV) is commonly performed in atrial fibrillation (AF). We examined the association between atrial fibrosis quantified using late gadolinium enhancement MRI (LGE-MRI) and acute success and recurrence of AF following DCCV. Methods: Persistent AF patients without previous catheter ablation who underwent LGE-MRI and DCCV were included in the study. Acute DCCV success was defined by achievement of sinus rhythm. Demographic patient data as well as comorbidities and medications were collected from chart revisions. Results: 241 patients were included (63% male). 186 patients (77.48%) were on oral anti-coagulation, 31 (12.9%) were on class I anti-arrhythmic drugs (AAD) and 46 (19.1%) were on class III AAD at the time of cardioversion. DCCV was acutely successful in 183 patients (75.9%). AF recurred after DCCV in 194 patients (80.5%) after an average follow up of 81 days. In univariate analysis, atrial fibrosis (HR 1.04; p=0.049) and body mass index (BMI) (HR 1.04; p=0.03) were associated with DCCV failure, while left atrial area, beta blocker, calcium channel blocker, class I and class III anti-arrhythmic drug use were not. In multivariate analysis, only atrial fibrosis was a significant predictor of DCCV failure (HR 1.03; p=0.03). During follow up, anti-arrhythmic drug use (class I drugs HR 0.21; p=0.045; class III drugs HR 0.27; p=0.042) was associated with maintenance of sinus rhythm. Conclusions: LGE-MRI quantified atrial fibrosis predicts failure of DCCV in persistent AF patients while AAD use was associated with maintenance of sinus rhythm.

Sign in / Sign up

Export Citation Format

Share Document