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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Observational Study
Evaluation of the current prognostic role of heart diseases in the history of patients with syncope.
Pivotal studies showed that the 1-year mortality was consistently higher in cardiogenic than in non-cardiogenic syncope 10 years later, further studies questioned these evidences, showing that the risk of death was only predicted by underlying heart disease and not from the syncope itself. Accordingly, nearly all the prognostic scales now include cardiovascular variables, but their definition is often neither unique nor precise and it might lead to an excessive hospitalization. ⋯ We recommend that emergency department physicians adopt a strict definition of heart diseases considered at risk to promptly identify all patients at risk for serious events, while avoiding an excessive hospitalization.
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An association between obstructive sleep apnoea (OSA) and atrial fibrillation (AF) has been established. However, studies on the role of OSA in AF recurrence after catheter ablation have yielded conflicting results, and the effect of OSA treatment by continuous positive airway pressure (CPAP) on the success rate of AF catheter ablation is indeterminate. The aim of this meta-analysis was to investigate the rate of AF recurrence after catheter ablation in patients with AF with or without OSA and to evaluate the relationship between CPAP therapy and AF recurrence. ⋯ Obstructive sleep apnoea was associated with AF recurrence after catheter ablation. The efficacy of catheter ablation for AF was similar between patients without OSA and patients with OSA undergoing CPAP treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study
Safety and efficacy of multipolar pulmonary vein ablation catheter vs. irrigated radiofrequency ablation for paroxysmal atrial fibrillation: a randomized multicentre trial.
The current challenge in atrial fibrillation (AF) treatment is to develop effective, efficient, and safe ablation strategies. This randomized controlled trial assesses the medium-term efficacy of duty-cycled radiofrequency ablation via the circular pulmonary vein ablation catheter (PVAC) vs. conventional electro-anatomically guided wide-area circumferential ablation (WACA). ⋯ NCT00678340.
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Recurrence of atrial fibrillation (AF) is frequently observed after AF catheter ablation. However, the predictive value of echocardiographic parameters associated with left ventricular diastolic dysfunction (LVDD) has not been well studied. ⋯ Early results of the catheter ablation, but not the late rhythm outcome, are influenced by an impaired mitral inflow pattern, which is associated with LVDD.
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Review Meta Analysis
An individual patient-based meta-analysis of the effects of dronedarone in patients with atrial fibrillation.
Dronedarone is a non-iodinated benzofuran derivative with antiarrhythmic properties. In placebo-controlled atrial fibrillation (AF) trials, the drug was found to have divergent effects on endpoints such as cardiovascular death or hospitalization. The objective of this meta-analysis of all placebo-controlled studies was to provide insights on possible reasons for these divergent effects. ⋯ This meta-analysis demonstrates significant heterogeneity of dronedarone treatment effects across the placebo-controlled randomized trials. The most important predictor of a harmful effect of dronedarone on cardiovascular death and heart failure hospitalization was the presence of permanent AF.