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LETTURA A TEMA Fibrillazione Atriale: Stato dell’Arte Prof. Luigi Padeletti

LETTURA A TEMA Fibrillazione Atriale: Stato dell’Arte Prof. Luigi Padeletti. Presenta: Saverio Iacopino. Sant ’ Anna Hospital Catanzaro. Network for person: Padeletti, Luigi. Network for person: Padeletti, Luigi. HF and AF are “ emerging epidemics ”.

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LETTURA A TEMA Fibrillazione Atriale: Stato dell’Arte Prof. Luigi Padeletti

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  1. LETTURA A TEMA Fibrillazione Atriale: Stato dell’Arte Prof. Luigi Padeletti Presenta: Saverio Iacopino Sant’Anna Hospital Catanzaro

  2. Network for person: Padeletti, Luigi

  3. Network for person: Padeletti, Luigi

  4. HF and AF are “emerging epidemics”

  5. The interaction between AF and HF means thatneither can be treated optimally without treating both promotes HF AF aggravates

  6. Ventricular resynchronization and • atrial pacing (algorithms, atrial • resynchronization) may be considered • a major revolution in treating AF and • HF by electrical stimulation

  7. Primary outcome: device-classified AT/AF frequency Secondary outcomes: device-classified AT/AF burden and PAC frequency Padeletti et al. JCE. 2003

  8. Long-term Reduction of AT Recurrences in Patients Paced for BT-SND In a long-term observation on BT-SND patients, a significant decrease of AT related hospitalizations and increase of mean AT cycle length were measured. These data suggest that rhythm control therapies may induce an inversion of AT progression. Padeletti et al. HR. 2005

  9. MASCOT Trial • Multicenter, single-blind, randomized, parallel study evaluating the safety and efficacy of a specific AOP algorithm (AF Suppression™, St Jude Medical, Sylmar, CA) in CRT patients. • After successful CRT device implantation, and before hospital discharge, the patients were randomly assigned to AOP ON versus OFF for the duration of follow-up. Padeletti et al. AHJ. 2008

  10. MASCOT Trial: Incidence of Permanent AF Padeletti et al. AHJ. 2008

  11. MASCOT Trial: Mortality Padeletti et al. AHJ. 2008

  12. The two options to treat AF are either rhythm control defined as the strategy to restore and maintain sinus rhythm or rate control defined as the strategy to maintain the patient in AF and avoid too fast and too slow ventricular rates….. Padeletti L. et al. EHJ 2007

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