A Randomized Controlled Trial of Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (The CAMTAF Trial)

Hunter, Ross J.; Berriman, Thomas; Diab, Ihab; Kamdar, R; Richmond, Laura; Baker, Victoria; Goromonzi, Farai; Sawhney, Vinit; Duncan, Edward; Page, Stephen P.; Ullah, Waqas; Unsworth, Beth; Mayet, Jamil; Dhinoja, Mehul; Earley, Mark J.; Sporton, Simon; Schilling, Richard J.

doi:10.1161/circep.113.000806

Cited by 419 publications

(417 citation statements)

References 49 publications

(61 reference statements)

Supporting

Mentioning

382

Contrasting

Unclassified

Order By: Relevance

“…At the same time, the data illustrate that CA may significantly improve cardiac function in patients with HF and AF, which corroborates the conclusions of previously published studies (15)(16)(17). Furthermore, the present study has revealed that hs-CRP, duration of AF and LAD are independent predictors of higher recurrence rates of AF in patients with HF.…”

Section: Discussionsupporting

confidence: 92%

Rosuvastatin reduces the recurrence rate following catheter ablation for atrial fibrillation in patients with heart failure

Zhao

Liu

et al. 2017

Biomedical Reports

View full text Add to dashboard Cite

Abstract. The aim of the present study was to assess whether rosuvastatin could reduce the recurrence rate of atrial fibrillation (AF) in patients with heart failure (HF) following catheter ablation (CA). A total of 107 patients with HF and AF who underwent CA of AF by endocardial mapping and radiofrequency between June 2012 and May 2014 were recruited. The patients were randomly divided into three subgroups: i) Administered with 10 mg rosuvastatin daily following ablation (group 1, n=36); ii) administered with 20 mg rosuvastatin daily following ablation (group 2, n=36); and iii) only treated with conventional treatment of HF following ablation (group 3, n=35). After the procedure, patients were followed in the outpatient clinic by interrogation of Holter monitoring. The AF recurrence rate of group 2 was low in comparison with group 1 (22.2% vs. 38.9%, P= 0.013) and group 3 (22.2% vs. 48.6%, P=0.021). In comparison with baseline, the parameters of the left ventricular ejection fraction, left atrial diameter (LAD), and the levels of N-terminal pronatriuretic peptide and hypersensitive C-reactive protein (hs-CRP) were all improved in three groups. Furthermore, multivariate analysis demonstrated that LAD [hazard ratio (HR): 1.12, 95% confidence interval (CI): 1.06-1.67, P=0.049], hs-CRP (HR: 1.37, 95% CI: 1.11-1.92, P=0.002) and duration of AF (HR: 1.14, 95% CI: 1.09-1.18, P= 0.011) were independent predictors of AF recurrence in patients with HF following CA. Therefore, the present study has demonstrated that treatment with 20 mg rosuvastatin daily following CA was able to significantly decrease the recurrence rate of AF in patients with HF, and LAD, hs-CRP, and duration of AF were independent predictors of AF recurrence in patients with HF following CA.In conclusion, the present study has also demonstrated that CA may improve cardiac function in patients with HF and AF.

show abstract

Section: Discussionsupporting

confidence: 92%

Rosuvastatin reduces the recurrence rate following catheter ablation for atrial fibrillation in patients with heart failure

Zhao

Liu

et al. 2017

Biomedical Reports

View full text Add to dashboard Cite

show abstract

“…The results from this early study also contrast with more recent findings from the Catheter Ablation Versus Medical Rate Control for Atrial Fibrillation in Patients With Heart Failure (ARC-HF) and Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (CAMTAF) trials, which both showed significant improvement in exercise capacity and QoL with AF ablation in comparison with pharmacological rate control. 14,36 The CAMTAF trial also showed a significant improvement of LVEF after 6 months of follow-up with AF ablation in comparison with pharmacological rate control (+8.1 [95% CI, 3.0-13.1] versus -3 [95% CI, -7.7 to 0.5]; P<0.001). 36 Similarly, the ARC-HF trial reported a trend toward a higher LVEF improvement with AF ablation (mean difference, +5.6% (95% CI, −0.1 to +11.3; P=0.055) after 12 months of follow-up.…”

Section: Circulationmentioning

confidence: 96%

Ablation Versus Amiodarone for Treatment of Persistent Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted Device

et al. 2016

View full text Add to dashboard Cite

T ranscatheter ablation represents a valid treatment option in patients with drug-refractory symptomatic atrial fibrillation (AF). 1 The majority of catheter ablation trials have mainly enrolled patients with preserved left ventricular (LV) systolic function. In these patients, the ablative treatment has been shown to be effective in reducing morbidity, 2-4 improving the quality of life (QoL), [3][4][5][6] and improving functional capacity. 5-7Background-Whether catheter ablation (CA) is superior to amiodarone (AMIO) for the treatment of persistent atrial fibrillation (AF) in patients with heart failure is unknown. Methods and Results-Thiswas an open-label, randomized, parallel-group, multicenter study. Patients with persistent AF, dualchamber implantable cardioverter defibrillator or cardiac resynchronization therapy defibrillator, New York Heart Association II to III, and left ventricular ejection fraction <40% within the past 6 months were randomly assigned (1:1 ratio) to undergo CA for AF (group 1, n=102) or receive AMIO (group 2, n=101). Recurrence of AF was the primary end point. All-cause mortality and unplanned hospitalization were the secondary end points. Patients were followed up for a minimum of 24 months. At the end of follow-up, 71 (70%; 95% confidence interval, 60%-78%) patients in group 1 were recurrence free after an average of 1.4±0.6 procedures in comparison with 34 (34%; 95% confidence interval, 25%-44%) in group 2 (log-rank P<0.001). The success rate of CA in the different centers after a single procedure ranged from 29% to 61%. After adjusting for covariates in the multivariable model, AMIO therapy was found to be significantly more likely to fail (hazard ratio, 2.5; 95% confidence interval, 1.5-4.3; P<0.001) than CA. Over the 2-year follow-up, the unplanned hospitalization rate was (32 [31%] in group 1 and 58 [57%] in group 2; P<0.001), showing 45% relative risk reduction (relative risk, 0.55; 95% confidence interval, 0.39-0.76). A significantly lower mortality was observed in CA (8 [8%] versus AMIO (18 [18%]; P=0.037). Conclusions-This multicenter randomized study shows that CA of AF is superior to AMIO in achieving freedom from AF at long-term follow-up and reducing unplanned hospitalization and mortality in patients with heart failure and persistent AF. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00729911. However, a significant number of patients with AF also have LV systolic dysfunction. AF and heart failure (HF) frequently coexist and are often associated with several common predisposing risk factors such as hypertension, coronary artery disease, structural heart disease (nonischemic, valvular), diabetes mellitus, obesity, and obstructive sleep apnea . 8,9 Importantly, the prevalence of AF increases with HF severity, ranging from 5% in functional class I patients to ≈50% in class IV patients.Also, the prevalence of HF in patients with AF has been estimated at 42%. 8 The combination of HF and AF leads to deleterious hemodynamic and symp...

show abstract

“…113,433 Numerous studies have evaluated the efficacy of catheter ablation of both paroxysmal and persistent atrial fibrillation with significant impairment of systolic function. 437,[466][467][468][469][470][471][472][473] The weight of evidence is that sinus rhythm can be successfully achieved in 50 -80% of patients although repeat procedures are common and follow-up periods are usually not more than 12 months. Successful ablation has been associated with significant improvements in ejection fraction and reduction in atrial size in the majority of studies.…”

Section: Age and Atrial Fibrillation Ablationmentioning

confidence: 99%

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

et al. 2016

View full text Add to dashboard Cite

A Randomized Controlled Trial of Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (The CAMTAF Trial)

Cited by 419 publications

References 49 publications

Rosuvastatin reduces the recurrence rate following catheter ablation for atrial fibrillation in patients with heart failure

Rosuvastatin reduces the recurrence rate following catheter ablation for atrial fibrillation in patients with heart failure

Ablation Versus Amiodarone for Treatment of Persistent Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted Device

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

Contact Info

Product

Resources

About