title: The North American experience with the Ablate and Pace Trial (APT) for medically refractory atrial fibrillation.
abstract: The Ablate and Pace Trial (APT) was a prospective registry study of clinical outcomes and survival following ablation and pacing therapy for medically refractory atrial fibrillation. One hundred and fifty-six patients were enrolled at 16 centres in North America. The mean patient age was 66 +/- 11 years, with mean left ventricular ejection fraction of 48% +/- 18%. Seventy-eight percent of the patients had structural heart disease. During one year of follow up, multiple measures of quality-of-life showed significant and sustained improvement following ablation and pacing therapy. Also, left ventricular ejection increased significantly for patients with baseline left ventricular ejection fraction <45%. Metabolic exercise testing showed trends toward improved exercise tolerance; however, these did not achieve statistical significance. The one year overall survival was 85%, with 3% of patients experiencing sudden death. In summary, this large, non-randomized, trial showed significant improvement in quality of life and left ventricular function following ablation and pacing therapy. Ablation and pacing therapy is a viable strategy for palliative management of patients with medically refractory, highly symptomatic atrial fibrillation.
authors.affiliation: Medical College of Virginia, Richmond 23298, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Wood
authors.forename: G N
authors.initials: GN
authors.lastname: Kay
authors.forename: K A
authors.initials: KA
authors.lastname: Ellenbogen
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001283:Atrioventricular Node / Q000601:surgery*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D011788:Quality of Life; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D000889:Anti-Arrhythmia Agents