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https://hdl.handle.net/2440/52204
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dc.contributor.author | Khan, M. | - |
dc.contributor.author | Jais, P. | - |
dc.contributor.author | Cummings, J. | - |
dc.contributor.author | Di Biase, L. | - |
dc.contributor.author | Sanders, P. | - |
dc.contributor.author | Martin, D. | - |
dc.contributor.author | Kautzner, J. | - |
dc.contributor.author | Hao, S. | - |
dc.contributor.author | Themistoclakis, S. | - |
dc.contributor.author | Fanelli, R. | - |
dc.contributor.author | Potenza, D. | - |
dc.contributor.author | Massaro, R. | - |
dc.contributor.author | Wazni, O. | - |
dc.contributor.author | Schweikert, R. | - |
dc.contributor.author | Saliba, W. | - |
dc.contributor.author | Wang, P. | - |
dc.contributor.author | Al-Ahmad, A. | - |
dc.contributor.author | Beheiry, S. | - |
dc.contributor.author | Santarelli, P. | - |
dc.contributor.author | Starling, R. | - |
dc.contributor.author | et al. | - |
dc.date.issued | 2008 | - |
dc.identifier.citation | New England Journal of Medicine, 2008; 359(17):1778-1785 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.issn | 1533-4406 | - |
dc.identifier.uri | http://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.statementofresponsibility | Mohammed N. Khan,...Prashanthan Sanders, et al. | - |
dc.language.iso | en | - |
dc.publisher | Massachusetts Medical Soc | - |
dc.source.uri | http://dx.doi.org/10.1056/nejmoa0708234 | - |
dc.subject | PABA-CHF Investigators | - |
dc.subject | Pulmonary Veins | - |
dc.subject | Humans | - |
dc.subject | Atrial Fibrillation | - |
dc.subject | Postoperative Complications | - |
dc.subject | Anti-Arrhythmia Agents | - |
dc.subject | Stroke Volume | - |
dc.subject | Catheter Ablation | - |
dc.subject | Cardiac Pacing, Artificial | - |
dc.subject | Combined Modality Therapy | - |
dc.subject | Follow-Up Studies | - |
dc.subject | Physical Endurance | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.title | Pulmonary-vein isolation for atrial fibrillation in patients with heart failure | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1056/NEJMoa0708234 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Sanders, P. [0000-0003-3803-8429] | - |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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