Pulsed field ablation as initial therapy for persistent atrial fibrillation (Registro nro. 22760)

000 -Cabecera
Campo de control interno 03128nam a2200289 4500
001 - Número de control
control field ESSALUD
005 - Fecha y hora de la última transacción
Campo de control 20260804235550.0
007 - Tipo material - Descripcion fisica - info general
Tipo material - Descripcion fisica - info general ta
008 - Elementos de Longitud Fija - Información General
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040 ## - Origen de la Catalogación
Origen de la Catalogación BMG
041 ## - Idioma
Idioma eng
100 ## - Autor
Autor Wazni, Oussama M.
Rol del Autor Autor
9 (RLIN) 53862
245 ## - Titulo
Titulo Pulsed field ablation as initial therapy for persistent atrial fibrillation
300 ## - Páginas
Paginación páginas: 2407-2418
520 ## - Resumen
Resumen Background: Guidelines recommend a trial of antiarrhythmic drugs before catheter ablation for persistent atrial fibrillation. Whether pulsed field ablation (PFA) may be a preferred initial treatment is unclear.<br/>Methods: We conducted an international, randomized trial involving patients with previously untreated persistent atrial fibrillation. The patients were randomly assigned in a 2:1 ratio to receive PFA performed with a pentaspline catheter or to receive antiarrhythmic-drug therapy. An additional group of patients (PFA-assigned) underwent PFA for the analysis of the primary safety end point alone. All the patients received an insertable cardiac monitor. The primary effectiveness end point was the short-term and long-term success of treatment through 12 months. Short-term success was defined as procedural success in the PFA group and the absence of ablation during the blanking period (90 days after treatment initiation) in the antiarrhythmic-drug group. Long-term success was defined as freedom from recurrence of atrial arrhythmias, repeat ablation, or need for antiarrhythmic drugs from 90 days through 12 months (in the PFA group) and freedom from amiodarone use at any time. The primary safety end point was device- and procedure-related serious adverse events. Results: <br/>At 12 months, treatment success was observed in 128 of 207 patients (Kaplan–Meier estimate, 56%; 95% confidence interval [CI], 48 to 63) in the PFA group and in 40 of 103 patients (Kaplan–Meier estimate, 30%; 95% CI, 21 to 40) in the antiarrhythmic-drug group (hazard ratio for composite treatment failure [a lack of short- and long-term success], 0.46; 95% CI, 0.33 to 0.65; P<0.001). A primary safety end-point event occurred in 13 of 257 patients (5.1%) in the combined PFA group (both randomized and PFA-assigned groups). At 12 months, serious adverse events had occurred in 45 patients (25%) in the PFA group and in 20 patients (21%) in the antiarrhythmic-drug group.<br/>Conclusions: Among patients with persistent atrial fibrillation, the risk of recurrence of atrial arrhythmia was significantly lower among those who received PFA as first-line treatment than among those who received antiarrhythmic-drug therapy.
650 ## - Temas - Descriptores
Temas - Descriptores ARRITMIAS
9 (RLIN) 53863
650 ## - Temas - Descriptores
Temas - Descriptores MARCAPASOS
9 (RLIN) 53864
650 ## - Temas - Descriptores
Temas - Descriptores DESFIBRILADORES
9 (RLIN) 53865
650 ## - Temas - Descriptores
Temas - Descriptores CARDIOLOGÍA
9 (RLIN) 11301
700 ## - Autor Personal
Autor Personal Chun, Julian
9 (RLIN) 53866
700 ## - Autor Personal
Autor Personal Nair, Devi G.
9 (RLIN) 53867
700 ## - Autor Personal
Autor Personal Anic, Ante
9 (RLIN) 53868
700 ## - Autor Personal
Autor Personal Duytschaever, Mattias
9 (RLIN) 53869
700 ## - Autor Personal
Autor Personal Chrispin, Jonathan
9 (RLIN) 53870
773 0# - Revista (Relacion con el numero)
Host Biblionumber 22717
Host Itemnumber 22639
Ciudad, Editorial Massachusetts NEJM Group
Codigo barras item/ejemplar NEJM006
Titulo de la Revista The New England Journal of Medicine
Número de control de registro ESSALUD
ISSN 0028-4793
942 ## - Elementos de Koha
Tipo de Documento Artículos
Fecha procesamiento 2026-07-31
Catalogador SQB

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