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(Circulation. 2005;111:2865.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	FREEDOM FROM ATRIAL TACHYARRHYTHMIAS AFTER CATHETER ABLATION OF ATRIAL FIBRILLATION: A RANDOMIZED COMPARISON BETWEEN 2 CURRENT ABLATION STRATEGIES, by Karch et al.

 
Catheter ablation for maintaining sinus rhythm increasingly is considered when atrial fibrillation is highly symptomatic despite antiarrhythmic drug therapy. Rapidly activating regions in and around the pulmonary veins are causative in many patients. Ablation techniques targeting these regions, reported results, and complications vary among centers. Comparative data for different approaches are limited. The randomized trial by Karch et al in this issue of Circulation compared 2 more commonly used approaches: ablation encircling a wide area around the pulmonary vein ostia guided by anatomy, versus an electrogram-guided approach ablating only segments of the pulmonary vein ostia. In contrast to a previous trial, the segmental ablation approach was associated with better arrhythmia control. Many recurrences were asymptomatic in both groups. Serious complications included tamponade, pulmonary vein stenosis, and thromboemboli. These findings add fuel to the continuing controversy as to the optimal method and support the practice of confining this procedure to highly symptomatic patients. See p 2875.

	PERCUTANEOUS CORONARY INTERVENTION VERSUS CONSERVATIVE THERAPY IN NONACUTE CORONARY ARTERY DISEASE: A META-ANALYSIS, by Katritsis and Ioannidis.

 
Clinicians have often debated the incremental benefit of percutaneous coronary interventions for patients with stable angina. This study sought to synthesize the existing data by conducting a meta-analysis of the 11 randomized clinical trials of medical therapy versus percutaneous coronary intervention (PCI) in patients with angiographically documented coronary stenoses in nonacute coronary artery disease settings. The study specifically sought to determine whether PCI was associated with a subsequent reduction in risk of mortality, cardiac death or myocardial infarction, nonfatal myocardial infarction, and coronary artery bypass grafting or PCI. The follow-up was more than 2 . . . [Full Text of this Article]

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