RT-146
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Ablate and pace for paroxysmal
atrial fibrillation: epidemiology, short and long term results
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Michele Brignole, Carlo Menozzi,
Lorella Gianfranchi, Gino Lolli.
Arrhythmologic Center, Ospedali Riuniti, Lavagna, Department of Cardiology and
Arrhythmologic Center, Ospedale S. Maria Nuova, Reggio Emilia, Italy
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Abstract
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We performed a prospective randomized 6-month
evaluation of the clinical effects of atrioventricular junction ablation and DDDR
mode-switching pacemaker versus pharmacological treatment in 43 patients with intolerable,
paroxysmal atrial fibrillation not controlled with antiarrhythmic drugs. Ablation and
pacemaker treatment was highly effective and superior to drug therapy in controlling
symptoms and improving quality of life. However, the discontinuation of drug therapy
exposed patients to further recurrences of paroxysmal atrial fibrillation and the risk of
developing permanent atrial fibrillation.
Among 63 patients affected by symptomatic drug-refractory paroxysmal atrial
fibrillation who had undergone atrioventricular junction ablation and dual-chamber
pacemaker implantation, the actuarial estimate of progression of permanent atrial
fibrillation was 22%, 40% and 56% respectively 1, 2 and 3 years after ablation.
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Key Words
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Atrial fibrillation – RF catheter ablation
of AV junction
paroxysmal AF, pacemaker (DDDR mode), pharmacological treatment, epidemiology, quality of
life, PAF trial, OA
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