Cardioversion vs. Catheter Ablation for Persistent Atrial Fibrillation

Launched by DEUTSCHES HERZZENTRUM MUENCHEN · Sep 19, 2005

Keywords

ClinConnect Summary

This randomized study compares two treatment strategies in patients with persistent atrial fibrillation: Cardioversion vs. catheter ablation. Cardioversion is a low risk standard treatment option for patients with persistent atrial fibrillation. However, mid- and long term efficacy (regarding the maintenance of sinus rhythm) is low. Catheter ablation is an invasive treatment which has been reported to result in up to 60-70% of patients in stable sinus rhythm. However, it is a potentially dangerous invasive procedure with potentially fatal complications.

Comparison: External cardioversion v...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age \>20 years and \<75 years
• • documented persistent atrial fibrillation for at least 3 months (documented in at least 2 ECGs or holter-ECGs during the previous 3 months before inclusion and persistent atrial fibrillation in a 7-d-holter)
• • documented sufficient anticoagulation for at least 4 weeks before inclusion
• Exclusion Criteria:
• • Paroxysmal atrial fibrillation
• • NYHA IV (if recompensation is not possible)
• • Contraindication for warfarin
• • Disturbance of blood coagulation
• • Myocardial infarction, PTCA/stenting, bypass-operation, stroke, intracranial bleeding less than 3 months before
• • Reversible causes of atrial fibrillation (i.e. hyperthyroidism)
• • Pregnancy
• • LA-diameter \> 55mm
• • LV-function \< 30% EF
• • Aortic or mitral stenosis or regurgitation III°-IV°
• • Prosthetic valves