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GAP-AF study helps to define optimal approach to ablation
Date:6/25/2013

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In the GAP-AF (AFNET1) study between February 2006 and August 2010, 233 patients with drug refractory paroxysmal AF were randomized to have either a complete procedure (n=117) or an incomplete procedure (n=116). For the incomplete procedure the EPs stopped the radiofrequency application at one site to permit reconduction from the circumference. The study, which was performed in seven German centres, was funded by the German Atrial Fibrillation Network (AFNET). The inclusion criteria for the study were that patients had to be aged over 55 years and to have been treated with one anti arrhythmic drug before they entered the trial. Patients with poor left ventricular function were excluded from the study.

The primary endpoint of the study was the time to first recurrence of symptomatic AF with duration of more than 30 seconds on trans-telephonic ECG monitoring, or detection of asymptomatic AF defined as two consecutive recordings of AF during a minimum of 72 hours. The study made use of the RhythmCard technology, a small credit card sized device that patients can place on their chest wall to record an ECG whenever they experienced symptoms of AF and transmit the data via the telephone. Additionally, patients were asked to record and transmit an ECG every day regardless of their symptoms.

Results showed that at the three month follow-up, sinus rhythm (normal beating of the heart) had been achieved in 37.8% (46)of patients who had complete ablation, versus 20.8% (26) with incomplete ablation (P<0.001). Furthermore, the mean number of days in sinus rhythm was 60 days for the complete group versus 16 days for the incomplete group (P<0.001).

At three months, when patients were taken back to the EP lab for a repeat investigation, 70 % of those randomised to complete PVI had gaps versus 89% randomised to incomplete PVI.

No significant differences were found for serious adverse events (including syncope, stroke, major bleeding, tam
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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