Catheter ablation vs. antiarrhythmic drug treatment of persistent atrial fibrillation : A multicentre, randomized, controlled trial (SARA study)
Mont, Lluís (Hospital Clínic i Provincial de Barcelona)
Bisbal, Felipe (Hospital Clínic i Provincial de Barcelona)
Hernández-Madrid, Antonio (Hospital Universitario Ramón y Cajal (Madrid))
Pérez-Castellano, Nicasio (Hospital Clínico San Carlos (Madrid))
Viñolas, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Arenal, Angel (Hospital General Universitario Gregorio Marañón)
Arribas, Fernendo (Hospital 12 de Octubre (Madrid))
Fernández-Lozano, Ignacio (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Bodegas, Andrés (Hospital de Cruces (Barakaldo, Biscaia))
Cobos, Albert (Universitat de Barcelona)
Matía, Roberto (Hospital Universitario Ramón y Cajal (Madrid))
Pérez-Villacastín, Julián (Hospital Clínico San Carlos (Madrid))
Guerra Ramos, José María (Institut d'Investigació Biomèdica Sant Pau)
Ávila, Pablo (Hospital General Universitario Gregorio Marañón)
López-Gil, María (Hospital 12 de Octubre (Madrid))
Castro, Victor (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Arana, José Ignacio (Hospital de Cruces (Barakaldo, Biscaia))
Brugada, Josep 1958- (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2014
Resumen:	BackgroundCatheter ablation (CA) is a highly effective therapy for the treatment of paroxysmal atrial fibrillation (AF) when compared with antiarrhythmic drug therapy (ADT). No randomized studies have compared the two strategies in persistent AF. The present randomized trial aimed to compare the effectiveness of CA vs. ADT in treating persistent AF. Methods and resultsPatients with persistent AF were randomly assigned to CA or ADT (excluding patients with long-standing persistent AF). Primary endpoint at 12-month follow-up was defined as any episode of AF or atrial flutter lasting >24 h that occurred after a 3-month blanking period. Secondary endpoints were any atrial tachyarrhythmia lasting >30 s, hospitalization, and electrical cardioversion. In total, 146 patients were included (aged 55 ± 9 years, 77% male). The ADT group received class Ic (43. 8%) or class III drugs (56. 3%). In an intention-to-treat analysis, 69 of 98 patients (70. 4%) in the CA group and 21 of 48 patients (43. 7%) in the ADT group were free of the primary endpoint (P = 0. 002), implying an absolute risk difference of 26. 6% (95% CI 10. 0-43. 3) in favour of CA. The proportion of patients free of any recurrence (>30 s) was higher in the CA group than in the ADT group (60. 2 vs. 29. 2%; P < 0. 001) and cardioversion was less frequent (34. 7 vs. 50%, respectively; P = 0. 018). ConclusionCatheter ablation is superior to medical therapy for the maintenance of sinus rhythm in patients with persistent AF at 12-month follow-up. Clinical Trial Registration InformationNCT00863213 (http://clinicaltrials. gov/ct2/show/NCT00863213).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Antiarrhythmic drug ; Atrial fibrillation ; Atrial flutter ; Catheter ablation ; Clinical trial
Publicado en:	European heart journal, Vol. 35 Núm. 8 (21 2014) , p. 501-507, ISSN 1522-9645

DOI: 10.1093/eurheartj/eht457
PMID: 24135832

7 p, 320.0 KB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
Artículos > Artículos de investigación
Artículos > Artículos publicados