A Trial of Circumferential Pulmonary Vein Ablation (CPVA) Versus Antiarrhythmic Drug Therapy in for Paroxysmal Atrial Fibrillation (AF)

Summary

Background: Circumferential pulmonary vein ablation (CPVA) has been safely and effectively performed for treating paroxysmal atrial fibrillation (PAF); however, its safety and efficacy, as compared with those of antiarrhythmic drug therapy (ADT), have never been formally assessed in a randomized controlled trial. The Purpose of this study was to evaluate CPVA versus ADT in patients with PAF in a randomized controlled trial.

Timeline

Start

2005-01

Primary completion

—

Completion

2006-05

Outcome

Met primary endpoint

paper 72.7% of patients in the ablation arm and 56.5% of those initially randomly assigned to AADs were free of recurrent atrial fibrillation/atrial tachycardia (P=0.017). PMID 21946315 ↗

paper With follow-up extended to 4 years after randomly assigned, ablation remains superior to antiarrhythmic drug in these patients with paroxysmal atrial fibrillation. PMID 21946315 ↗

Publications

• Pappone C, Vicedomini G, Augello G, Manguso F, Saviano M, Baldi M, Petretta A, Giannelli L, Calovic Z, Guluta V, Tavazzi L, Santinelli V. Radiofrequency catheter ablation and antiarrhythmic drug therapy: a prospective, randomized, 4-year follow-up trial: the APAF study. Circ Arrhythm Electrophysiol. 2011 Dec;4(6):808-14. doi: 10.1161/CIRCEP.111.966408. Epub 2011 Sep 23.
• Pappone C, Augello G, Sala S, Gugliotta F, Vicedomini G, Gulletta S, Paglino G, Mazzone P, Sora N, Greiss I, Santagostino A, LiVolsi L, Pappone N, Radinovic A, Manguso F, Santinelli V. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J Am Coll Cardiol. 2006 Dec 5;48(11):2340-7. doi: 10.1016/j.jacc.2006.08.037. Epub 2006 Oct 16.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Amiodarone	Small molecule	—	—
Subject	flecainide	Small molecule	—	—
Subject	sotalol	Small molecule	—	—

Indications