المؤلفون: Ratika Parkash, George A. Wells, Jean Rouleau, Mario Talajic, Vidal Essebag, Allan Skanes, Stephen B. Wilton, Atul Verma, Jeffrey S. Healey, Laurence Sterns, Matthew Bennett, Jean-Francois Roux, Lena Rivard, Peter Leong-Sit, Mats Jensen-Urstad, Umjeet Jolly, Francois Philippon, John L. Sapp, Anthony S.L. Tang, Paul MacDonald, Santabhanu Chakrabarti, John Yeung-Lai-Wah, Andrew Ignaszewski, Stanley Tung, Shahnawaz Virani, Marc Deyell, Andrew Krahn, Jason Andrade, Lynn Straatman, Mustafa Toma, Graham Wong, Matthew Wei, Isabelle Greiss, Jean-Marc Raymond, Benoit Coutu, Paolo Costi, Fadi Mansour, Wouter Saint-Phard, Isabelle Denis, Julie Fleury, Felix Ayala-Paredes, Mariano Badra-Verdu, Charles Dussault, Nadia Vachon, Véronique Dagenais, Caroline Lamoureux, Jeff Healey, Stuart Connolly, C. Sebastien Ribas, Syamkumar Divakaramenon, Jorge Wong, Guy Amit, Wendy Meyer, Isabelle Nault, Jean Champagne, Jean-Francois Sarrazin, Gilles O’Hara, Louis Blier, Benoit Plourde, Christian Steinburg, Karine Roy, Paule Banville, Brigitte Ottinger, Marie-Eve Boucher, Marina Sanchez, Marc Dubuc, Peter Guerra, Katia Dyrda, Paul Khairy, Laurent Macle, Blandine Mondesert, Denis Roy, Bernard Thibault, Rafik Tadros, Véronique Roy, Damian Redfearn, Hoshiar Abdollah, Adrian Baranchuk, Kevin Michael, Christopher Simpson, Sharlene Hammond, Brian Clarke, Carlos Morillo, Vikas Kuriachan, George Veenhuyzen, Russell Quinn, Derek Exner, Jonathan Howlett, Jennifer McKeage, Lorne Gula, Jaimie Manlucu, Anthony Tang, George Klein, Sabrina Wall, Yomna El-Sakka, Tom Hadjis, Martin Bernier, Jacqueline Joza, Jean- Francois Roux, Alexander Omelchenko, Thais Nascimento, Fiorella Rafti, Ida DiStefano, John Sapp, Chris Gray, Martin Gardner, Amir Abdel-Wahab, Ciorsti J MacIntyre, Miroslaw Rajda, Patrick O’Regan, Mary Lee Levins-Lamont, Evan Lockwood, Tom Hruczkowski, Lucas Valtuille, Michael Chan, Jennifer Halenar, Samantha McLean, Yaariv Khaykin, Lynn Nyman, Zaev Wulffhart, Alfredo Pantano, Bernice Tsang, Sherri Patterson, Annette Nath, Clause Rinne, Irene Janzen, Eugene Crystal, Ilan Lashevsky, Sheldon Singh, Irving Tiong, Ambreen Syeda, Anyur Tremblay, Andrew C. T. Ha, Vijay Chauhan, Ann Hill, Pablo Nery, David Birnie, Calum Redpath, Martin Green, Girish Nair, Robert Lemery, Mouhannad Sadek, Karen MacDonald, Paul Novak, Richard Leather, Elizabeth Swiggum, Markus Sikkel, Chris Lane, Tanner Rakochey, Caitlin Patterson, Tiago Luiz Luz Leiria, Gustavo Glotz de Lima, Roberto Sant’Anna, Eduardo Dutz, Cristina Klein Weber, Aline Peixoto Deiro, Laís Machado Hoscheidt, Cecile Linde, Ott Saluveer, Carina Carnlof, Chih-Chieh Yu, Fu-Chun Chiu, Jiunn-Lee Lin, Cheng-Yu Huang, Patricia Theoret-Patrick, Janine Ryan, My-Linh Tran, Li Chen, Sarah Singh, George Wells, Gary Newton, Doug Coyle, George Wyse, Dennis Cassidy, Lehana Thabane, Lisa Mielniczuk, Andrew Ha, TIago Luiz Luz Leiria, Niko Tzemos, Andrew Mathew, De Thain, Anita MacDonald, Marcia Shields

المصدر: Circulation. 145(23)

مصطلحات موضوعية: Heart Failure, Treatment Outcome, Physiology (medical), Atrial Fibrillation, Catheter Ablation, Quality of Life, Humans, Stroke Volume, Cardiology and Cardiovascular Medicine, Ventricular Function, Left

الوصف: Background: Atrial fibrillation (AF) and heart failure (HF) frequently coexist and can be challenging to treat. Pharmacologically based rhythm control of AF has not proven to be superior to rate control. Ablation-based rhythm control was compared with rate control to evaluate if clinical outcomes in patients with HF and AF could be improved. Methods: This was a multicenter, open-label trial with blinded outcome evaluation using a central adjudication committee. Patients with high-burden paroxysmal (>4 episodes in 6 months) or persistent (duration Results: From December 1, 2011, to January 20, 2018, 411 patients were randomly assigned to ablation-based rhythm control (n=214) or rate control (n=197). The primary outcome occurred in 50 (23.4%) patients in the ablation-based rhythm-control group and 64 (32.5%) patients in the rate-control group (hazard ratio, 0.71 [95% CI, 0.49–1.03]; P =0.066). Left ventricular ejection fraction increased in the ablation-based group (10.1±1.2% versus 3.8±1.2%, P =0.017), 6-minute walk distance improved (44.9±9.1 m versus 27.5±9.7 m, P =0.025), and NT-proBNP demonstrated a decrease (mean change –77.1% versus –39.2%, P P =0.0036), as did the AF Effect on Quality of Life score (least-squares mean difference of 6.2 [95% CI, 1.7–10.7]; P =0.0005). Serious adverse events were observed in 50% of patients in both treatment groups. Conclusions: In patients with high-burden AF and HF, there was no statistical difference in all-cause mortality or HF events with ablation-based rhythm control versus rate control; however, there was a nonsignificant trend for improved outcomes with ablation-based rhythm control over rate control. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01420393.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::359d4af73554c6bfa5d18a989630505d
https://pubmed.ncbi.nlm.nih.gov/35858115