@Article{RSM:Kha2004,
  author =       "Y. Khaykin and N.F. Marrouche and W. Saliba and R.
                 Schweikert and D. Bash and M.S. Chen and M.
                 Williams-Andrews and E. Saad and D.J. Burkhardt and M.
                 Bhargava and G. Joseph and A. Rossillo and D. Erciyes
                 and D. Martin and A. Natale",
  title =        "Pulmonary vein antrum isolation for treatment of
                 atrial fibrillation in patients with valvular heart
                 disease or prior open heart surgery.",
  journal =      j-HR,
  year =         "2004",
  volume =       "1",
  number =       "1",
  pages =        "33--39",
  robnote =      "afib, OBJECTIVES: The goal of this study was to assess
                 the safety and efficacy of pulmonary vein antrum
                 isolation in patients with moderate valvular heart
                 disease or open-heart surgery and atrial fibrillation
                 (AF). BACKGROUND: Valvular heart disease and open-heart
                 surgery are commonly associated with AF and increase
                 the risk of adverse events in AF patients. METHODS: A
                 total of 391 consecutive patients who had pulmonary
                 vein antrum isolation performed between December 2000
                 and December 2002 were screened. A total of 142 of
                 these patients had clinically significant valvular
                 disease or prior cardiac surgery. End points included
                 AF recurrence and pulmonary vein antrum isolation
                 complication rates. RESULTS: Patients with valvular
                 heart disease or prior open-heart surgery were older,
                 had larger left atria and a more advanced New York
                 Heart Association class. They did not differ
                 significantly with respect to gender, but had a longer
                 history of AF. Procedure times were similar between
                 patients with and without valvular heart disease or
                 prior open-heart surgery. After 18 +/- 7 months in the
                 lone AF patients, 11 +/- 5 months in patients with
                 valvular heart disease, and 10 +/- 5 months in patients
                 with prior open heart surgery, there was a trend toward
                 lower recurrence of AF in patients with lone AF who
                 enjoyed a 98\% overall cure rate after up to 2
                 pulmonary vein antrum isolations versus 93\% among
                 patients with valvular heart disease (P = .04) and
                 prior open heart surgery (P = .07). Complication rates
                 were comparable between groups. CONCLUSIONS: Pulmonary
                 vein antrum isolation is safe and effective in patients
                 with moderate valvular heart disease and the patients
                 who developed AF after open-heart surgery. These
                 results have implications for our understanding of the
                 pathophysiology of AF in patients with moderate
                 valvular heart disease or past cardiac surgery and
                 should be considered when discussing treatment options
                 in these patients.",
  bibdate =      "Thu Jun 28 00:49:02 2007",
}