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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn a trial with only persistent atrial fibrillation (PeAF) patients, as opposed to a combination of PeAF and paroxysmal AF patients, catheter ablation had significantly better results at 12-month follow-up than antiarrhythmic drug treatment. This article presents the results of the Study of Ablation Versus Antiarrhythmic Drugs in Persistent Atrial Fibrillation [SARA; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00863213\u0026amp;atom=%2Fspmdc%2F13%2F12%2F14.atom\u0022\u003ENCT00863213\u003C\/a\u003E].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn a trial with only persistent atrial fibrillation (PeAF) patients, as opposed to a combination of PeAF and paroxysmal AF (PAF) patients, catheter ablation (CA) had significantly better results at 12-month follow-up than antiarrhythmic drug (AAD) treatment. Lluis Mont, MD, PhD, Hospital Clinic, Universitat de Barcelona, Catalonia, Spain, presented the results of the Study of Ablation Versus Antiarrhythmic Drugs in Persistent Atrial Fibrillation [SARA; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00863213\u0026amp;atom=%2Fspmdc%2F13%2F12%2F14.atom\u0022\u003ENCT00863213\u003C\/a\u003E].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPast trials have combined patients with PeAF and long-standing PeAF, but no trial has excluded long-standing patients, Prof. Mont said. In this case, researchers tried to define a purely PeAF group of patients, those in transition from PAF to long-standing PeAF, he said. They conducted the trial at eight hospitals across Spain.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe researchers randomized 146 patients in a 2:1 ratio, with 98 patients randomized to receive CA and 48 to receive AAD treatment. Eligible patients had symptomatic PeAF \u0026gt;7 days, or \u0026lt;7 days if cardioversion was required, and they had failed one or more Class I or Class III AADs. Exclusion criteria included age \u0026lt;18 and \u0026gt;70 years, long-standing PeAF, advanced remodeling stage (left atrial [LA] \u0026gt;50 mm), hyper- or hypothyroidism, hypertrophic cardiomyopathy, disease contradicting ablation or AAD treatment, and other factors.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary ablation procedure was a wide encircling pulmonary vein ablation with a cooledtip catheter, assisted by a circular multipolar catheter, with a primary endpoint of absence or dissociation of local activity inside the surrounded region and exit block. Additional ablation lines, with the endpoint of complete bidirectional conduction block or ablation of complex fractionated atrial electrograms (CFAEs) were done according to each hospital\u0027s protocol. AADs in the control group were either Class Ic plus diltiazem or \u03b2-blockers or Class III.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EFor the intention-to-treat (ITT) analysis, 70.4% of CA patients achieved the primary endpoint of freedom of any sustained episode of AF \u0026gt;24 hours, compared with 43.7% of AAD patients for an absolute risk reduction of 26.6% (95% CI, 10.0 to 43.4; p=0.002). CA patients also experienced greater benefit in secondary outcomes (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/13576\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/13576\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13576\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ESARA Secondary Endpoints\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EFollow-up consisted of physician visits and electrocardiogram at Months 1, 3, 6, and 12, a 24-hour Holter monitor at Months 3, 6, and 12, and physician contact at any time if symptoms occurred.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EBaseline patient characteristics included mean age of 55 years, 77% male, LA size between 41.3 mm (CA group) and 42.7 mm (AAD group), and left ventricular ejection fraction of 61.1% (CA group) and 60.8% (AAD group).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EIn the CA-randomized patients, 94.9% actually underwent CA (8 patients withdrew or were lost to follow-up but were included in the analysis), and 8.2% underwent additional CA. Of those, 23.4% had roof line, 3.1% had mitral line, and 8.1% CFAE ablation. Of the AAD-randomized patients, initial therapy was Class I for 43.8% and Class III for 56.3%, for a mean of 1.3\u00b10.7 AADs per patient. No strokes or deaths occurred during the study.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/12\/14.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznpuq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nznpuq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}