PMID- 20078622
OWN - NLM
STAT- MEDLINE
DCOM- 20100415
LR  - 20161125
IS  - 1751-7133 (Electronic)
IS  - 1527-5299 (Linking)
VI  - 16
IP  - 1
DP  - 2010 Jan-Feb
TI  - Ablation vs medical therapy in the setting of symptomatic atrial fibrillation and 
      left ventricular dysfunction.
PG  - 10-4
LID - 10.1111/j.1751-7133.2009.00116.x [doi]
AB  - Small, single-center studies suggest that catheter ablation of atrial 
      fibrillation (AF) can improve ventricular function and reduce symptoms in 
      patients with left ventricular (LV) dysfunction. However, ablation has not been 
      compared with a pharmacologic strategy for AF. The authors evaluated patients 
      with AF and symptomatic LV dysfunction (ejection fraction < or =45%) referred for 
      pulmonary vein isolation (PVI). They compared these patients with a matched 
      cohort treated medically for AF and LV dysfunction via a retrospective 
      case-control method. Fifteen patients (14 men, 56+/-11 years, 10 [67%] paroxysmal 
      AF) with AF for 4+/-3 years underwent PVI. Baseline ejection fraction was 
      37%+/-6% and New York Heart Association (NYHA) class was 2.0+/-1.0. Fifteen 
      controls (13 men, 63+/-14 years, 11 [73%] paroxysmal AF) with AF for 5+/-4 years 
      were treated medically for AF. Baseline ejection fraction was 34%+/-11% and NYHA 
      class was 2.0+/-0.7. The groups were similar in all respects. During a follow-up 
      of 16+/-13 months after complete PVI, ejection fraction improved (P=.001) to 
      50%+/-13% and normalized in 8 patients (53%). NYHA class improved to 1.3+/-0.5 
      (P=.01). In the medically treated group, after follow-up of 16+/-12 months, no 
      improvement in ejection fraction (36%+/-12%) or NYHA class (1.8+/-0.7) was seen. 
      Compared with pharmacologic therapy, PVI significantly improved LV function and 
      NYHA class in patients with AF and symptomatic LV dysfunction. These provocative 
      findings provide potent rationale for a randomized clinical trial comparing 
      ablation with pharmacologic therapy.
CI  - 2009 Wiley Periodicals, Inc.
FAU - Choi, Andrew D
AU  - Choi AD
AD  - Al-Sabah Arrhythmia Institute and Division of Cardiology, St. Luke's and 
      Roosevelt Hospitals, Columbia University College of Physicians & Surgeons, New 
      York, NY, USA.
FAU - Hematpour, Khashayar
AU  - Hematpour K
FAU - Kukin, Marrick
AU  - Kukin M
FAU - Mittal, Suneet
AU  - Mittal S
FAU - Steinberg, Jonathan S
AU  - Steinberg JS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Congest Heart Fail
JT  - Congestive heart failure (Greenwich, Conn.)
JID - 9714174
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Atrial Fibrillation/diagnostic imaging/*drug therapy/*surgery
MH  - Case-Control Studies
MH  - *Catheter Ablation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Veins/surgery
MH  - Retrospective Studies
MH  - Statistics, Nonparametric
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*drug therapy/*surgery
EDAT- 2010/01/19 06:00
MHDA- 2010/04/16 06:00
CRDT- 2010/01/19 06:00
PHST- 2010/01/19 06:00 [entrez]
PHST- 2010/01/19 06:00 [pubmed]
PHST- 2010/04/16 06:00 [medline]
AID - CHF116 [pii]
AID - 10.1111/j.1751-7133.2009.00116.x [doi]
PST - ppublish
SO  - Congest Heart Fail. 2010 Jan-Feb;16(1):10-4. doi: 
      10.1111/j.1751-7133.2009.00116.x.