Catheter Ablation of Atrial Fibrillation in Patients with Diabetes Mellitus Type 2: Results from a Randomized Study Comparing Pulmonary Vein Isolation Versus Antiarrhythmic Drug Therapy

Forleo, Giovanni B.; Mantica, Massimo; Luca, Lucia De; Leo, Roberto; Santini, Luca; Panigada, Stefania; Sanctis, Valerio De; Pappalardo, Augusto; Laurenzi, Francesco; Avella, Andrea; Casella, Michela; Russo, Antonio Dello; Romeo, Francesco; Pelargonio, Gemma; Tondo, Claudio

doi:10.1111/j.1540-8167.2008.01275.x

Cited by 126 publications

(95 citation statements)

References 28 publications

(28 reference statements)

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“…Mniej jest dostępnych danych na temat skuteczności i bezpieczeństwa ablacji przezcewnikowej u pacjentów z przetrwałym lub długotrwale przetrwałym AF, ale wszystkie one wskazują na mniejszą częstość nawrotów po ablacji przezcewnikowej w porównaniu z farmakoterapią antyarytmiczną, połączoną lub niepołączoną z kardiowersją (dodatkowa ryc. 2) [185,717,[723][724][725][726]1039]. U pacjentów doświadczających objawowych nawrotów AF mimo farmakoterapii antyarytmicznej we wszystkich RCT wykazano lepsze utrzymywanie rytmu zatokowego po ablacji przezcewnikowej niż podczas stosowania leków antyarytmicznych [586,713,727,728].…”

Section: Wskazaniaunclassified

“…W celu uzyskania kontroli objawów większość pacjentów wymaga więcej niż jednego zabiegu [713,726,728]. Zasadniczo rzecz biorąc, lepszych wyników leczenia pod względem utrzymywania rytmu zatokowego oraz mniejszej częstości występowania powikłań związanych z zabiegiem można oczekiwać u młodszych pacjentów z krótkimi wywiadami AF oraz często występującymi, krótkotrwałymi epizodami AF przy braku istotnej strukturalnej choroby serca [745].…”

Section: Wyniki Ablacji Przezcewnikowej Migotania Przedsionkówunclassified

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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,339

4,206

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Section: Wskazaniaunclassified

Section: Wyniki Ablacji Przezcewnikowej Migotania Przedsionkówunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,339

4,206

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“…Catheter ablation of AF provides a possibility to maintain sinus rhythm without the use of AADs in the large proportion of selected patients with AF, and it represents a promising alternative to available pharmacological therapy for rhythm control. Table 2 presents several randomized studies which compared efficiency and safety of AADs versus catheter ablation for the treatment of patients with AF [90][91][92][93][94][95][96][97][98][99]. Clinical follow-up in these studies most often was 1 year, whilst only one study reported long term results.…”

Section: Figure 3 Catheter Ablation Of Persistent Af: Pv Isolation Amentioning

confidence: 99%

“…propafenone, flecainide and disopyramide) or class III AAD (i.e. sotalol, amiodarone and dofetilide) [91][92][93][94][95][96][97]99]. In addition, two studies compared the results of transcatheter and pharmacological therapy as the first therapeutic option in patients with previously untreated AF [90,98].…”

Section: Figure 3 Catheter Ablation Of Persistent Af: Pv Isolation Amentioning

confidence: 99%

Catheter Ablation of Lone Atrial Fibrillation

Mujović

Marinković²,

Potpara³

et al. 2014

CPD

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Atrial fibrillation is the most common sustained arrhythmia in clinical practice, associated with increased mortality, risk of stroke and heart failure, as well as the reduction of the quality of life. Atrial fibrillation may be encountered in young otherwise healthy individuals, due to the isolated electrophysiological disorder limited mostly to the pulmonary veins and posterior left atrial wall, or associated with the presence of advanced underlying heart disease and numerous cardiac and non-cardiac comorbidities with significant structural remodeling of the atrial myocardium. Due to limited efficacy and serious side effects of antiarrhythmic drugs, catheter ablation of atrial fibrillation, based on the pulmonary vein isolation for paroxysmal atrial fibrillation and adjunctive substrate modification for persistent atrial fibrillation, has emerged as an attractive and promissing alternative therapeutic option for selected patients with atrial fibrillation. In this review article, we discuss the electrophysiological left atrial abnormalities underlying lone atrial fibrillation and the role of pulmonary veins in pathophysiology of arrhythmia, and we summarize results of the studies on the long term outcome of catheter ablation of atrial fibrillation, as well as the studies on comparison of antiarrhythmic drugs with catheter ablation for treatment of atrial fibrillation. In addition, we present available data that provide better understanding of mechanisms, diagnosis, prevention and treatment of specific procedure-related complications and discuss current periprocedural anticoagulation strategies and their impact on the thromboembolic risk reduction.

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“…However, the management recommendations and guidelines have not yet reached a consensus with regard to the use of catheter ablation for the treatment of AF, primarily due to the differences in ablation strategy and technique employed in different centers, in addition to relevant complications (5,6,8). In previous years, a number of small to moderately sized randomized controlled trials (RCTs) have been published that directly compare the efficacy of catheter ablation and AADs for the treatment of AF (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). However, the number of patients enrolled in each study was limited.…”

Section: Introductionmentioning

confidence: 99%

Effect of catheter ablation versus antiarrhythmic drugs on atrial fibrillation: A meta-analysis of randomized controlled trials

Shi

Heng

Liu

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to compare the health outcomes of catheter ablation therapy against those of antiarrhythmic drugs (AADs) in the management of atrial fibrillation (AF). The effects of catheter ablation and AADs on a number of parameters were compared, including AF recurrence, all-cause mortality, stroke/transient ischemic attack (TIA) and quality of life (QoL). A systematic literature search of PubMed, Embase and the Cochrane Central Register of Controlled Trials was conducted to obtain relevant randomized controlled trials. The relative risks (RRs) and 95% confidence intervals (CIs) of AF recurrence, all-cause mortality and stroke/TIA between catheter ablation and AADs were subsequently calculated. Weighted mean differences (WMDs) and 95% CIs were used to evaluate the QoL between the two therapy groups. In total, 11 randomized trials, which included 1,763 AF patients, were eligible for the meta-analysis. Overall, the results indicated that catheter ablation produces superior outcomes compared with AADs in reducing AF recurrence (RR, 0.47; 95% CI, 0.38-0.58; P<0.001) and improving the QoL (physical component summary: WMD, 2.23; 95% CI, 0.24-4.21; P= 0.03; mental component summary: WMD, 2.69; 95% CI, 0.04-5.35; P= 0.05). However, no statistically significant difference was identified between the two groups with regard to the incidence of all-cause mortality (RR, 0.87; 95% CI, 0.37-2.06; P= 0.76) and stroke/TIA (RR, 1.83; 95% CI, P=0.20). In summary, catheter ablation was demonstrated to markedly reduce AF recurrence and improve QoL when compared with AAD therapy. However, the incidence rates of all-cause mortality and stroke/TIA were comparable between catheter ablation and AAD therapy.

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Catheter Ablation of Atrial Fibrillation in Patients with Diabetes Mellitus Type 2: Results from a Randomized Study Comparing Pulmonary Vein Isolation Versus Antiarrhythmic Drug Therapy

Abstract: In patients with DM2, CA of AF provides significant clinical benefits over the ADT and appears to be a reasonable approach regarding feasibility, effectiveness, and low procedural risk.

Cited by 126 publications

References 28 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Catheter Ablation of Lone Atrial Fibrillation

Effect of catheter ablation versus antiarrhythmic drugs on atrial fibrillation: A meta-analysis of randomized controlled trials

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