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Atrial Fibrillation

A4 study: proof of concept?

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The A4 and other similar (small) studies strongly support the launch of major trials of left atrial catheter ablation for the maintenance of sinus rhythm, reduction of cardiovascular hospitalizations and improved survival in patients with symptomatic recurrent atrial fibrillation. Will pharmacological therapies continue to have an important place in the management of atrial fibrillation?

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References

  1. Cappato, R. et al. Fatalities in catheter ablation of atrial fibrillation. J. Am. Coll. Cardiol. (in press).

  2. Jaïs, P. et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation 118, 2498–2505 (2008).

    Article  Google Scholar 

  3. Krittayaphong, R. et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. J. Med. Assoc. Thai. 86 (Suppl. 1), S8–S16 (2003).

    PubMed  Google Scholar 

  4. Wazni, O. M. et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 293, 2634–2640 (2005).

    Article  CAS  Google Scholar 

  5. Stabile, G. et al. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study). Eur. Heart J. 27, 216–221 (2006).

    Article  Google Scholar 

  6. Oral, H. et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N. Engl. J. Med. 354, 934–941 (2006).

    Article  CAS  Google Scholar 

  7. Pappone, C. et al. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J. Am. Coll. Cardiol. 48, 2340–2347 (2006).

    Article  CAS  Google Scholar 

  8. Forleo, G. B. et al. Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. J. Cardiovasc. Electrophysiol. 20, 22–28 (2009).

    Article  Google Scholar 

  9. Hindricks, G. et al. Perception of atrial fibrillation before and after radiofrequency catheter ablation: relevance of asymptomatic arrhythmia recurrence. Circulation 112, 307–313 (2005).

    Article  Google Scholar 

  10. Hohnloser, S. H. et al. Effect of dronedarone on cardiovascular events in atrial fibrillation. N. Engl. J. Med. 360, 668–678 (2009).

    Article  CAS  Google Scholar 

  11. Miyasaka, Y. et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 114, 119–125 (2006).

    Article  Google Scholar 

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Authors and Affiliations

  1. St George's University of London, London, UK

    A. John Camm & Irina Savelieva

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  1. A. John Camm
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  2. Irina Savelieva
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Correspondence to A. John Camm.

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Competing interests

A.J. Camm has declared that he is a consultant for Sanofi Aventis, Cardiome/Astellas and Boston Scientific, and has received speakers bureau from Sanofi Aventis and Cardiome/Astellas. I. Savelieva has declared no competing interests.

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Camm, A., Savelieva, I. A4 study: proof of concept?. Nat Rev Cardiol 6, 332–334 (2009). https://doi.org/10.1038/nrcardio.2009.49

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