Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction

Prabhu, Sandeep; Taylor, Andrew J.; Costello, Ben; Kaye, David M.; McLellan, A.; Voskoboinik, Aleksandr; Sugumar, Hariharan; Lockwood, S.; Stokes, Michael B.; Pathik, B.; Nalliah, C.; Wong, G.; Azzopardi, Sonia; Gutman, S.; Lee, Geoffrey; Layland, Jamie; Mariani, Justin A.; Ling, Liang‐Han; Kalman, Jonathan M.; Kistler, Peter M.

doi:10.1016/j.jacc.2017.08.041

Cited by 473 publications

(433 citation statements)

References 28 publications

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“…Anti‐Arrhythmic Drug Therapy for Atrial Fibrillation (http://clinicaltrials.gov identifier‐ NCT 00911508) and Early Treatment of Atrial Fibrillation for Stroke Prevention (http://clinicaltrials.gov identifier‐ NCT01288352) trials are in progress to address this question. Recently, however, in patients with heart failure reduced ejection fraction and AF, an ablation strategy compared to pharmacological rate/rhythm therapy has been shown to improve left ventricular systolic function as well as reduce heart failure hospitalisation and all‐cause mortality…”

Section: Discussionmentioning

confidence: 99%

Trends in outpatient anti‐arrhythmic prescriptions for atrial fibrillation and left atrial ablation in Australia: 1997–2016

Khan

Patel

Nanayakkara

et al. 2018

Internal Medicine Journal

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A rhythm control strategy is frequently utilised for AF management in Australia. Consistent with international guidelines which advocate safety over efficacy when choosing a rhythm control strategy, the prescriptions of amiodarone have been consistently decreasing since 2002, whereas sotalol and flecainide prescriptions have largely increased, with a peak in 2015. Catheter ablation per capita has burgeoned 36-fold.

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Section: Discussionmentioning

confidence: 99%

Trends in outpatient anti‐arrhythmic prescriptions for atrial fibrillation and left atrial ablation in Australia: 1997–2016

Khan

Patel

Nanayakkara

et al. 2018

Internal Medicine Journal

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“…The CAMERA-MRI multicenter trial (Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction) 15 showed that catheter ablation of AF was associated with an improvement in EF when compared with medical rate control (18% versus 4% improvement in EF) with a higher likelihood of normalization to ≥50% (58% versus 9%). The absence of LV late gadolinium enhancement by magnetic resonance imaging (MRI) predicted greater improvements in LV EF.…”

Section: Af Ablation In Heart Failurementioning

confidence: 99%

Year in Review in Cardiac Electrophysiology

Tzou

Hussein

Madhavan

et al. 2018

Circ: Arrhythmia and Electrophysiology

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1 In the past year, there have been key advances in our understanding of arrhythmia mechanisms and diagnosis and important new therapies. We have seen advances in basic cardiac electrophysiology with demonstration of optogenetic targeting of atrial fibrillation (AF) rotors, induced pluripotent stem cell-based biological pacemakers, small-conductance Ca 2+ -activated K + (SK) channels as targets for AF treatment, and reductions in inward rectifier potassium current in promoting ventricular fibrillation. Hand-held ECG devices and implantable loop recorders have been shown to detect subclinical AF. Catheter ablation of AF in patients with left ventricular dysfunction improves outcomes compared with medical therapy. Both hybrid thoracoscopic surgical and catheter ablation procedures and off-pump surgery for AF have demonstrated efficacy. Anticoagulation with uninterrupted dabigatran had a lower major bleeding rate compared with uninterrupted warfarin after AF ablation. Studies have examined optimizing access to automatic external defibrillators by identifying optimal locations for placement and possibility of using a drone delivery network. In long-QT syndrome, there are advances in understanding of ECG predictors of arrhythmic events, the role of the role of gene variants in conferring arrhythmic risk, and effect of age and sex on QTc interval. There are numerous advances in the treatment of ventricular tachycardia, including noninvasive cardiac radiation. Catheter ablation and implantable devices continue to demonstrate effectiveness in patients with congenital heart disease.In the past year, there have been numerous ground-breaking discoveries and observations that illustrate the vibrancy and promise of our field. In this review, we have tried to capture articles published in the year 2017 of particular interest to cardiac electrophysiologists. Although we have focused on articles from our journal, we have captured many of the most impactful articles in numerous other journals. We apologize for omitting a large number of other important articles that cannot be included in this review because of space limitations. We have placed some of these in our Data Supplement. BASIC ELECTROPHYSIOLOGY BradyarrhythmiasThe search for new biological therapies for bradycardia met with recent progress as human keratinocytes genetically reprogrammed into electrically unstable cardiomyocytes were shown to persist and provide continued catecholaminergic-responsive pacing for 13 weeks after subepicardial injection into immunosuppressed dogs at the time of atrioventricular (AV) node ablation.1 Although only 40% to 80% of the beats matched the site of cell injection, this is first study to test a human induced pluripotent stem cell-based biological pacemaker in a large animal model of heart block and represents an important step forward in biological pacing.

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“…In another study of 1269 patients who underwent atrial flutter ablation, AIC was observed in 56% of the patients with concomitant LVSD 7. Furthermore, it was recently demonstrated that restoration of sinus rhythm with catheter ablation in patients with AF and LVSD results in significant improvements in LVEF compared with sole frequency control 6. The CASTLE‐AF study further revealed that catheter ablation for AF in patients with LVSD is associated with significant reduction of death from any cause and hospitalization for worsening heart failure 8.…”

Section: Discussionmentioning

confidence: 98%