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http://hdl.handle.net/2445/132516
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DC Field | Value | Language |
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dc.contributor.author | Castellà, Manuel | - |
dc.contributor.author | Kotecha, Dipak | - |
dc.contributor.author | van, Laar Charlotte | - |
dc.contributor.author | Wintgens, Lisette | - |
dc.contributor.author | Castillo, Yakir | - |
dc.contributor.author | Kelder, Johannes | - |
dc.contributor.author | Aragon, David | - |
dc.contributor.author | Núñez, María | - |
dc.contributor.author | Sandoval, Elena | - |
dc.contributor.author | Casellas, Aina | - |
dc.contributor.author | Mont Girbau, Lluís | - |
dc.contributor.author | van Boven, Wim Jan | - |
dc.contributor.author | Boersma, Lucas V. A. | - |
dc.contributor.author | van Putte, Bart P. | - |
dc.date.accessioned | 2019-04-29T10:59:38Z | - |
dc.date.available | 2019-04-29T10:59:38Z | - |
dc.date.issued | 2019-05 | - |
dc.identifier.issn | 1099-5129 | - |
dc.identifier.uri | http://hdl.handle.net/2445/132516 | - |
dc.description.abstract | Aims: Our objectives were to compare effectiveness and long-term prognosis after epicardial thoracoscopic atrial fibrillation (AF) ablation vs. endocardial catheter ablation, in patients with prior failed catheter ablation or high risk of failure. Methods and results: Patients were randomized to thoracoscopic or catheter ablation, consisting of pulmonary vein isolation with optional additional lines (2007–2010). Patients were reassessed in 2016/2017, and those without documented AF recurrence underwent 7-day ambulatory electrocardiography. The primary rhythm outcome was recurrence of any atrial arrhythmia lasting >30 s. The primary clinical endpoint was a composite of death, myocardial infarction, or cerebrovascular event, analysed with adjusted Cox proportional hazard ratios (HRs). One hundred and 24 patients were randomized with 34% persistent AF and mean age 56 years. Arrhythmia recurrence was common at mean follow-up of 7.0 years, but substantially lower with thoracoscopic ablation: 34/61 (56%) compared with 55/63 (87%) with catheter ablation [adjusted HR 0.40, 95% confidence interval (CI) 0.25–0.64; P < 0.001]. Additional ablation procedures were performed in 8 patients (13%) compared with 31 (49%), respectively (P < 0.001). Eleven patients (19%) were on anti-arrhythmic drugs at end of follow-up with thoracoscopy vs. 24 (39%) with catheter ablation (P = 0.012). There was no difference in the composite clinical outcome: 9 patients (15%) in the thoracoscopy arm vs. 10 patients (16%) with catheter ablation (HR 1.11, 95% CI 0.40–3.10; P = 0.84). Pacemaker implantation was required in 6 patients (10%) undergoing thoracoscopy and 3 (5%) in the catheter group (P = 0.27). Conclusion: Thoracoscopic AF ablation demonstrated more consistent maintenance of sinus rhythm than catheter ablation, with similar long-term clinical event rates. | - |
dc.format.extent | 8 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Oxford University Press | - |
dc.relation.isformatof | Reproducció del document publicat a: http://dx.doi.org/ 10.1093/europace/euy325 | - |
dc.relation.ispartof | Europace, 2019, vol. 21, num. 5, p. 746-753 | - |
dc.relation.uri | http://dx.doi.org/ 10.1093/europace/euy325 | - |
dc.rights | cc by-nc (c) Castellá et al., 2019 | - |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/es/ | - |
dc.source | Articles publicats en revistes (ISGlobal) | - |
dc.subject.classification | Fibril·lació auricular | - |
dc.subject.classification | Mortalitat | - |
dc.subject.other | Atrial fibrillation | - |
dc.subject.other | Mortality | - |
dc.title | Thoracoscopic vs. catheter ablation for atrial fibrillation: long-term follow-up of the FAST randomized trial | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.date.updated | 2019-02-14T15:29:26Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 30715255 | - |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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CastellaM_Europace_2019.pdf | 345.61 kB | Adobe PDF | View/Open |
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