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

T was given according to current guidelines, with class III drugs (amiodarone) recommended for patients with structural heart disease and class Ic (flecainide) plus dilitiazem or beta blockers for patients without structural heart disease. The inclusion criteria were that patients should have experienced symptomatic persistent AF (> seven days or 50mm anterioposterior diameters).

In an intention-to-treat analysis, the proportion of patients free of prolonged (>12 hours) AF at 12 months (the primary end-point) was 70.4% in the CA group versus 43.7% in the ADT group (p=0.002); implying an absolute risk difference of 26.6% (95% CI: 10.0-43.3) favouring ablation group.

The proportion of patients free of any recurrence of AF or flutter (lasting >30 seconds) was 60.2% in the CA group compared to 29.2% in the ADT group (p<0.001).

"Our study shows that, if proper selection criteria are applied, ablation can achieve good results for patients with persistent AF," said Mont. "It's likely to have an impact on guidelines and may contribute to an upgrade of ablation in persistent AF to category 1B." Results would not apply to patients with very dilated atrium and long standing persistent AF.

A challenge for increasing the number of ablation procedures taking place was likely to be the shortage of highly trained physicians. "But as happened years ago with coronary angioplasty, the demand is likely to increase the numbers of physicians and centres prepared to perform such procedures," said Prof. Mont.

Further studies, he added, are now needed looking at outcomes according to 'shape r
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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