Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
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Randomized Controlled Trial Comparative Study
Recurrence of paroxysmal atrial fibrillation after pulmonary vein isolation: is repeat pulmonary vein isolation enough? A prospective, randomized trial.
In patients with paroxysmal atrial fibrillation (pAF), pulmonary vein isolation (PVI) has become an accepted treatment option with single procedure success rates of 60-80%. A repeat ablation is performed in ∼30% of patients because of arrhythmia recurrence. The strategy for this repeat procedure is not defined. ⋯ In this prospective randomized trial, patients with a recurrence of paroxysmal AF had no better outcome after repeat PVI + one left atrial line compared with patients with repeat PVI only.
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Clinical Trial
One-year clinical success of a 'no-bonus' freeze protocol using the second-generation 28 mm cryoballoon for pulmonary vein isolation.
Studies on the use of the second-generation 28 mm cryoballoon (CB) for the treatment of atrial fibrillation (AF) have reported superior 1-year clinical outcome. Customarily, a bonus freeze cycle is applied after pulmonary vein isolation (PVI). The purpose of the present study was to assess the 1-year clinical outcome following PVI foregoing a bonus freeze cycle. ⋯ A 'no-bonus'-freeze protocol for PVI using the second-generation 28 mm CB resulted in an 82% 1-year clinical success rate. A bonus freeze cycle following successful PVI may not be essential to superior clinical outcome.
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Randomized Controlled Trial Multicenter Study
Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: a MADIT-RIT sub-study.
Data on the time-dependent benefit of cardiac resynchronization therapy with defibrillator (CRT-D) compared with a dual-chamber implantable cardioverter-defibrillator (ICD) to reduce death or ventricular tachycardia (VT) or ventricular fibrillation (VF) are limited. We aimed to evaluate the time-related risk of death or sustained VT or VF in patients receiving CRT-D vs. ICD in the MADIT-RIT trial. ⋯ http://clinicaltrials.gov/ct2/show/NCT00947310.
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Randomized Controlled Trial
Clinical course and prognostic relevance of antitachycardia pacing-terminated ventricular tachyarrhythmias in implantable cardioverter-defibrillator patients.
In patients with an implantable cardioverter-defibrillator (ICD), ICD shocks due to ventricular tachycardia (VT) or ventricular fibrillation (VF) have been associated with an increased mortality. It is not known whether patients with antitachycardia pacing (ATP)-terminated VT/VF episodes have a similar worse outcome. The aim of this study was to evaluate the clinical course and prognostic impact of ATP-terminated episodes on mortality in ICD patients. ⋯ In ICD patients, about three-fourths of ventricular arrhythmias are terminated by ATP. The occurrence of ATP-terminated episode is associated with an increased mortality rate.