Refinements and innovations enhance safety, eff...( the source of abnormal electrical impu...),Health

"The APAF trial is the first to compare medicinal therapy to catheter ablation for paroxysmal atrial fibrillation using a formal and appropriately powered randomized controlled study," said Carlo Pappone, M.D., Ph.D., chief of the division of cardiac pacing and electrophysiology, San Raffaele University Hospital, Milan, Italy.

"This study convincingly demonstrates superior efficacy with catheter ablation, even though we used intense, daily transtelephonic monitoring during follow-up."

The APAF study enrolled 198 patients who were experiencing, on average, three episodes of atrial fibrillation per month and had been unable to control the arrhythmia with medication. Researchers randomly assigned study participants to drug treatment with amiodarone, flecainide, or sotalol, or to a catheter procedure known as circumferential pulmonary vein ablation (CPVA). This technique uses a special catheter passed into the left side of the heart that can deliver radiofrequency energy, which is used to burn circular patterns around each of the four pulmonary veins where the abnormal electrical activity often originates. The resulting scar tissue prevents electrical impulses from escaping into the left atrium. Researchers also created three linear lesions, two at the back wall of the left atrium and one at near mitral valve that separates the left atrium from the left ventricle.

Early results from the first 99 patients followed-up for at least nine months showed that 84 percent of those who had catheter ablation were no longer experiencing paroxysmal atrial fibrillation, as compared to only 24 percent of patients treated with anti-arrhythmic medication.

Dr. Pappone will report clinical findings on 135 patients with a mi
'"/>


13-Mar-2006