Consistent survival benefit of carvedilol over metoprolol irrespective of baseline characteristics of heart failure patients – mode of death evaluation in COMET

2004 ◽  
Vol 10 (4) ◽  
pp. S84 ◽  
Author(s):  
Willem J. Remme ◽  
John G. Cleland ◽  
Andrea Di Lenarda ◽  
Christian Torp-Pederson ◽  
Marco Metra ◽  
...  
2011 ◽  
Vol 57 (14) ◽  
pp. E361
Author(s):  
Anupam Kumar ◽  
Sanjeev P. Bhavnani ◽  
Craig I. Coleman ◽  
Danette Guertin ◽  
Christopher A. Clyne ◽  
...  

2019 ◽  
Vol 25 (8) ◽  
pp. S45-S46
Author(s):  
Sujeen Adhikari ◽  
Ambar Andrade ◽  
Kathleen Kamba ◽  
Muhammad Khan ◽  
Sheraz Hussain ◽  
...  

2019 ◽  
Vol 25 (8) ◽  
pp. S111
Author(s):  
Jia Li ◽  
Ruicong She ◽  
Hongsheng Gui ◽  
Nicole Zeld ◽  
Hani N. Sabbah ◽  
...  

ESC CardioMed ◽  
2018 ◽  
pp. 2159-2162
Author(s):  
Maurizio Gasparini ◽  
Paola Galimberti

The atrioventricular junction ablation (AVJA) and pacing method has been a well-known strategy since the 1980s. It is nowadays essentially performed in two groups of patients. First of all, it is indicated in atrial fibrillation (AF) patients who have failed rhythm control with pulmonary vein isolation ablation and different medical rate control strategies. The procedure dramatically reduces symptoms and it is associated with an increase in ejection fraction in patients with AF-induced cardiomyopathy. The second group of patients is represented by heart failure patients with a cardiac resynchronization system presenting with a low biventricular pacing percentage due to a high AF burden. Several studies have documented the necessity to achieve the highest biventricular pacing to maximize cardiac resynchronization therapy (CRT) benefits. In this context of AF patient with CRT, AVJA is the only tool that allows complete rhythm regularization and heart rate control, thus favouring a ‘pure’, constant delivery of CRT, while negative chronotropic drug use is limited and device algorithms only partially effective. An improvement of symptoms, of left ventricular function, as well as survival benefit has been clearly documented after AVJA in AF CRT patients. The procedure is usually safe and effective; nonetheless, it is often perceived as a potentially harmful therapy that should be avoided as much as possible because it causes pacemaker dependency. However, no studies on conventional ablate and pace therapy have reported significant complications during the follow-up. Furthermore, the aforementioned benefits of AVJA in the heart failure population seem to well overweigh possible risks associated with pacemaker dependency.


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