Topic
Catheter ablation
About: Catheter ablation is a research topic. Over the lifetime, 16515 publications have been published within this topic receiving 426033 citations.
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TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Abstract: Background Atrial fibrillation, the most common sustained cardiac arrhythmia and a major cause of stroke, results from simultaneous reentrant wavelets. Its spontaneous initiation has not been studied. Methods We studied 45 patients with frequent episodes of atrial fibrillation (mean [±SD] duration, 344±326 minutes per 24 hours) refractory to drug therapy. The spontaneous initiation of atrial fibrillation was mapped with the use of multielectrode catheters designed to record the earliest electrical activity preceding the onset of atrial fibrillation and associated atrial ectopic beats. The accuracy of the mapping was confirmed by the abrupt disappearance of triggering atrial ectopic beats after ablation with local radio-frequency energy. Results A single point of origin of atrial ectopic beats was identified in 29 patients, two points of origin were identified in 9 patients, and three or four points of origin were identified in 7 patients, for a total of 69 ectopic foci. Three foci were in the right atrium...
7,487 citations
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TL;DR: Management of atrial fibrillation with the rhythm-control strategy offers no survival advantage over the rate- control strategy, and there are potential advantages, such as a lower risk of adverse drug effects, with the rate -control strategy.
Abstract: Background There are two approaches to the treatment of atrial fibrillation: one is cardioversion and treatment with antiarrhythmic drugs to maintain sinus rhythm, and the other is the use of rate-controlling drugs, allowing atrial fibrillation to persist. In both approaches, the use of anticoagulant drugs is recommended. Methods We conducted a randomized, multicenter comparison of these two treatment strategies in patients with atrial fibrillation and a high risk of stroke or death. The primary end point was overall mortality. Results A total of 4060 patients (mean [+/-SD] age, 69.7+/-9.0 years) were enrolled in the study; 70.8 percent had a history of hypertension, and 38.2 percent had coronary artery disease. Of the 3311 patients with echocardiograms, the left atrium was enlarged in 64.7 percent and left ventricular function was depressed in 26.0 percent. There were 356 deaths among the patients assigned to rhythm-control therapy and 310 deaths among those assigned to rate-control therapy (mortality at five years, 23.8 percent and 21.3 percent, respectively; hazard ratio, 1.15 [95 percent confidence interval, 0.99 to 1.34]; P=0.08). More patients in the rhythm-control group than in the rate-control group were hospitalized, and there were more adverse drug effects in the rhythm-control group as well. In both groups, the majority of strokes occurred after warfarin had been stopped or when the international normalized ratio was subtherapeutic. Conclusions Management of atrial fibrillation with the rhythm-control strategy offers no survival advantage over the rate-control strategy, and there are potential advantages, such as a lower risk of adverse drug effects, with the rate-control strategy. Anticoagulation should be continued in this group of high-risk patients.
3,988 citations
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TL;DR: An update of the 2010 ESC Guidelines for the management of atrial fibrillation with the special contribution of the European Heart Rhythm Association is developed.
Abstract: 2012 focused update of the ESC Guidelines for the management of atrial fibrillation : an update of the 2010 ESC Guidelines for the management of atrial fibrillation: developed with the special contribution of the European Heart Rhythm Association
3,986 citations
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TL;DR: A prospective, randomized, double blind, Active-controlled, superiority study of Vernakalant vs. amiodarone in Recent Onset atrial fibrillation for the prevention of cardiovascular Hospitalization or death from any cause.
Abstract: ACCF
: American College of Cardiology Foundation
ACCP
: American College of Chest Physicians
ACS
: acute coronary syndrome
ACT
: Atrial arrhythmia Conversion Trial
ADONIS
: American–Australian–African trial with DronedarONe In atrial fibrillation or flutter for the maintenance of Sinus rhythm
AF
: atrial fibrillation
AHA
: American Heart Association
ANDROMEDA
: ANtiarrhythmic trial with DROnedarone in Moderate-to-severe congestive heart failure Evaluating morbidity DecreAse
APHRS
: Asia Pacific Heart Rhythm Society
aPTT
: activated partial thromboplastin time
ARB
: angiotensin-receptor blocker
ARISTOTLE
: Apixaban for Reduction In STroke and Other ThromboemboLic Events in atrial fibrillation
ATHENA
: A placebo-controlled, double-blind, parallel arm Trial to assess the efficacy of dronedarone 400 mg b.i.d. for the prevention of cardiovascular Hospitalization or death from any cause in patiENts with Atrial fibrillation/atrial flutter
ATRIA
: AnTicoagulation and Risk factors In Atrial fibrillation
AVERROES
: Apixaban VErsus acetylsalicylic acid (ASA) to Reduce the Rate Of Embolic Stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment
AVRO
: A prospective, randomized, double-blind, Active-controlled, superiority study of Vernakalant vs. amiodarone in Recent Onset atrial fibrillation
b.i.d
: bis in die (twice daily)
b.p.m.
: beats per minute
CABANA
: Catheter ABlation vs . ANtiarrhythmic drug therapy for Atrial fibrillation
CABG
: coronary artery bypass graft
CAP
: Continued Access to Protect AF
CHA2DS2-VASc
: Congestive heart failure or left ventricular dysfunction Hypertension, Age ≥75 (doubled), Diabetes, Stroke (doubled)-Vascular disease, Age 65–74, Sex category (female)
CHADS2
: Congestive heart failure, Hypertension, Age ≥75, Diabetes, Stroke (doubled)
CI
: confidence interval
CRAFT
: Controlled Randomized Atrial Fibrillation Trial
CrCl
: creatinine clearance
DAFNE
: Dronedarone Atrial FibrillatioN study after Electrical cardioversion
DIONYSOS
: Randomized Double blind trIal to evaluate efficacy and safety of drOnedarone (400 mg b.i.d.) vs . amiodaroNe (600 mg q.d. for 28 daYS, then 200 mg qd thereafter) for at least 6 mOnths for the maintenance of Sinus rhythm in patients with atrial fibrillation
EAST
: Early treatment of Atrial fibrillation for Stroke prevention Trial
EHRA
: European Heart Rhythm Association
ECG
: electrocardiogram
EMA
: European Medicines Agency
ERATO
: Efficacy and safety of dRonedArone for The cOntrol of ventricular rate during atrial fibrillation
EURIDIS
: EURopean trial In atrial fibrillation or flutter patients receiving Dronedarone for the maIntenance of Sinus rhythm
FAST
: atrial Fibrillation catheter Ablation vs . Surgical ablation Treatment
FDA
: Food and Drug Administration
Flec-SL
: Flecainide Short-Long trial
HAS-BLED
: Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly
HF-PEF
: heart failure with preserved ejection fraction
HF-REF
: heart failure with reduced ejection fraction
HR
: hazard ratio
HRS
: Heart Rhythm Society
ICH
: intracranial haemorrhage
INR
: international normalized ratio
i.v.
: intravenous
J-RHYTHM
: Japanese RHYTHM management trial for atrial fibrillation
LAA
: left atrial appendage
LoE
: level of evidence
LVEF
: left ventricular ejection fraction
MANTRA-PAF
: Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation
NICE
: National Institute for Health and Clinical Excellence
NOAC
: novel oral anticoagulant
NSAID
: non-steroidal anti-inflammatory drug
NYHA
: New York Heart Association
OAC
: oral anticoagulant or oral anticoagulation
o.d.
: omni die (every day)
PALLAS
: Permanent Atrial fibriLLAtion outcome Study using dronedarone on top of standard therapy
PCI
: percutaneous coronary intervention
PREVAIL
: Prospective Randomized EVAluation of the LAA closure device In patients with atrial fibrillation v s. Long-term warfarin therapy
PROTECT AF
: WATCHMAN LAA system for embolic PROTECTion in patients with Atrial Fibrillation
PT
: prothrombin time
RAAFT
: Radio frequency Ablation Atrial Fibrillation Trial
RE-LY
: Randomized Evaluation of Long-term anticoagulant therapY with dabigatran etexilate
ROCKET-AF
: Rivaroxaban Once daily oral direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in atrial fibrillation
RRR
: relative risk reduction
TE
: thromboembolism
TIA
: transient ischaemic attack
t.i.d.
: ter in die (three times daily)
TOE
: transoesophageal echocardiogram
TTR
: time in therapeutic range
VKA
: vitamin K antagonist
Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on …
3,272 citations
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TL;DR: In this article, the authors proposed AMIOdarone versus implantable cardioverter-defibrillator (ICD-DV) for the treatment of atrial fibrillation.
Abstract: ACC
: American College of Cardiology
ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
AF
: atrial fibrillation
AGNES
: Arrhythmia Genetics in the Netherlands
AHA
: American Heart Association
AMIOVIRT
: AMIOdarone Versus Implantable cardioverter-defibrillator:
2,830 citations