Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/52204
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dc.contributor.authorKhan, M.-
dc.contributor.authorJais, P.-
dc.contributor.authorCummings, J.-
dc.contributor.authorDi Biase, L.-
dc.contributor.authorSanders, P.-
dc.contributor.authorMartin, D.-
dc.contributor.authorKautzner, J.-
dc.contributor.authorHao, S.-
dc.contributor.authorThemistoclakis, S.-
dc.contributor.authorFanelli, R.-
dc.contributor.authorPotenza, D.-
dc.contributor.authorMassaro, R.-
dc.contributor.authorWazni, O.-
dc.contributor.authorSchweikert, R.-
dc.contributor.authorSaliba, W.-
dc.contributor.authorWang, P.-
dc.contributor.authorAl-Ahmad, A.-
dc.contributor.authorBeheiry, S.-
dc.contributor.authorSantarelli, P.-
dc.contributor.authorStarling, R.-
dc.contributor.authoret al.-
dc.date.issued2008-
dc.identifier.citationNew England Journal of Medicine, 2008; 359(17):1778-1785-
dc.identifier.issn0028-4793-
dc.identifier.issn1533-4406-
dc.identifier.urihttp://hdl.handle.net/2440/52204-
dc.description.abstract<h4>Background</h4>Pulmonary-vein isolation is increasingly being used to treat atrial fibrillation in patients with heart failure.<h4>Methods</h4>In this prospective, multicenter clinical trial, we randomly assigned patients with symptomatic, drug-resistant atrial fibrillation, an ejection fraction of 40% or less, and New York Heart Association class II or III heart failure to undergo either pulmonary-vein isolation or atrioventricular-node ablation with biventricular pacing. All patients completed the Minnesota Living with Heart Failure questionnaire (scores range from 0 to 105, with a higher score indicating a worse quality of life) and underwent echocardiography and a 6-minute walk test (the composite primary end point). Over a 6-month period, patients were monitored for both symptomatic and asymptomatic episodes of atrial fibrillation.<h4>Results</h4>In all, 41 patients underwent pulmonary-vein isolation, and 40 underwent atrioventricular-node ablation with biventricular pacing; none were lost to follow-up at 6 months. The composite primary end point favored the group that underwent pulmonary-vein isolation, with an improved questionnaire score at 6 months (60, vs. 82 in the group that underwent atrioventricular-node ablation with biventricular pacing; P<0.001), a longer 6-minute-walk distance (340 m vs. 297 m, P<0.001), and a higher ejection fraction (35% vs. 28%, P<0.001). In the group that underwent pulmonary-vein isolation, 88% of patients receiving antiarrhythmic drugs and 71% of those not receiving such drugs were free of atrial fibrillation at 6 months. In the group that underwent pulmonary-vein isolation, pulmonary-vein stenosis developed in two patients, pericardial effusion in one, and pulmonary edema in another; in the group that underwent atrioventricular-node ablation with biventricular pacing, lead dislodgment was found in one patient and pneumothorax in another.<h4>Conclusions</h4>Pulmonary-vein isolation was superior to atrioventricular-node ablation with biventricular pacing in patients with heart failure who had drug-refractory atrial fibrillation. (ClinicalTrials.gov number, NCT00599976.)-
dc.description.statementofresponsibilityMohammed N. Khan,...Prashanthan Sanders, et al.-
dc.language.isoen-
dc.publisherMassachusetts Medical Soc-
dc.source.urihttp://dx.doi.org/10.1056/nejmoa0708234-
dc.subjectPABA-CHF Investigators-
dc.subjectPulmonary Veins-
dc.subjectHumans-
dc.subjectAtrial Fibrillation-
dc.subjectPostoperative Complications-
dc.subjectAnti-Arrhythmia Agents-
dc.subjectStroke Volume-
dc.subjectCatheter Ablation-
dc.subjectCardiac Pacing, Artificial-
dc.subjectCombined Modality Therapy-
dc.subjectFollow-Up Studies-
dc.subjectPhysical Endurance-
dc.subjectMiddle Aged-
dc.subjectFemale-
dc.subjectMale-
dc.titlePulmonary-vein isolation for atrial fibrillation in patients with heart failure-
dc.typeJournal article-
dc.identifier.doi10.1056/NEJMoa0708234-
pubs.publication-statusPublished-
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]-
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