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Pulmonary vein antrum isolation, atrioventricular junction ablation, and antiarrhythmic drugs combined with direct current cardioversion: survival rates at 7 years follow-up

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Abstract

Purpose

To report survival rates in patients treated with pulmonary vein antrum isolation (PVAI), atrioventricular junctional ablation (AVJA), and antiarrhythmic and direct current cardioversion (A + DCCV) at 7 years follow-up.

Methods

From February 2002–December 2004, 1,000 consecutive patients underwent PVAI or A + DCCV or AVJA. These patients were matched in a nested case-controlled methodology. Survival rates were compared at the end of 7 years.

Results

Three hundred and forty-five consecutive patients had undergone PVAI (34.5%), 157 (15.7%) consecutive patients AVJA, and 498(49.8%) A + DCCV. After matching the patients in a nested case-controlled methodology, 146 (32.3%) patients were in the PVAI group, 205 (59.4%) in the A + DCCV, and 101 (22.3%) in the AVJA.

At 69 ± 27 months, 63 (13.9%) patients had died in the matched population. Three (2.1%) patients died in the PVAI group, 34 (16.5%) in the A + DCCV group, and 26 (25.7%) in the AVJA group. In multivariable analysis, treatment strategy was a significant predictor of mortality. Compared to patients with PVAI (reference group), those with A + DCCV (HR 4.9, p = 0.011) and AVJA (HR 10.6, p = 0.001) procedures had higher mortality risk.

Conclusion

Compared to the other two procedures, patients with PVAI had the best survival rates at the end of 7 years. However, the observational case-control design of this study incurs the potential for confounding due to non-randomized treatment selection, and creates a major limitation in making valid generalization of the findings.

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Authors and Affiliations

  1. Magdeburg, Germany

    Kai Sonne

  2. Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, TX, USA

    Dimpi Patel, Prasant Mohanty, Luigi Di Biase, Preeti Venkatraman, Mazen Shaheen, J. David Burkhardt, Robert Canby & Andrea Natale

  3. Mc Master University, Ontario, Canada

    Luciana Armaganijan

  4. IKEM, Prague, Czech Republic

    Lucie Riedlbauchova & Marketa Kozeluhova

  5. University of Cairo, Cairo, Egypt

    Moataz El-Ali

  6. Cleveland Clinic, Cleveland, OH, USA

    Robert Schweikert, Oussama Wazni & Walid Saliba

Authors
  1. Kai Sonne
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  2. Dimpi Patel
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  3. Prasant Mohanty
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  4. Luciana Armaganijan
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  7. Luigi Di Biase
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  11. Robert Schweikert
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  12. J. David Burkhardt
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  13. Robert Canby
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  14. Oussama Wazni
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  15. Walid Saliba
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  16. Andrea Natale
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Correspondence to Andrea Natale.

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Sonne, K., Patel, D., Mohanty, P. et al. Pulmonary vein antrum isolation, atrioventricular junction ablation, and antiarrhythmic drugs combined with direct current cardioversion: survival rates at 7 years follow-up. J Interv Card Electrophysiol 26, 121–126 (2009). https://doi.org/10.1007/s10840-009-9436-1

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  • DOI: https://doi.org/10.1007/s10840-009-9436-1

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