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(Circulation. 2006;114:1669.)
© 2006 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. |
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RESULTS FROM THE LOIRE-ARDÈCHE-DRÒME-ISÈRE-PUY-DE-DÒME (LADIP) TRIAL ON ATRIAL FLUTTER, A MULTICENTRIC PROSPECTIVE RANDOMIZED STUDY COMPARING AMIODARONE AND RADIOFREQUENCY ABLATION AFTER THE FIRST EPISODE OF SYMPTOMATIC ATRIAL FLUTTER, by Da Costa et al. |
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Right atrial flutter is often recurrent despite antiarrhythmic drug therapy. It is effectively managed with catheter ablation, but atrial fibrillation, which may also warrant antiarrhythmic therapy, emerges in a substantial portion of patients during follow-up. Da Costa and colleagues conducted a randomized trial to compare catheter ablation to chronic therapy with amiodarone in elderly patients after their first episode of atrial flutter. Ablation was extremely effective in preventing recurrent atrial flutter, and was more effective than amiodarone. During follow-up treatment, amiodarone did not significantly lower the incidence of atrial fibrillation as compared with catheter ablation of the atrial flutter. These data support catheter ablation as a reasonable first line therapy for common right atrial flutter in the elderly. Whether such an approach would translate into less antiarrhythmic drug toxicity and fewer hospitalizations compared with cardioversion or other antiarrhythmic drug therapies warrants further study. See p 1676.
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GENE TRANSFER OF A SYNTHETIC PACEMAKER CHANNEL INTO THE HEART: A NOVEL STRATEGY FOR BIOLOGICAL PACING, by Kashiwakura et al. |
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The use of ion-channel gene therapy for creating biological pacemakers has been an area of great interest, as electronic devices have limited longevity and are prone to lead failure, particularly in younger patients. Recent studies have used either the natural or genetically-modified hyperpolarization-activated nucleotide-gated channel gene in different animal models of sinus node dysfunction or atrioventricular block. In this issue of Circulation, Kashiwakura et al report their results of experiments using a novel bioengineered human Kv1.4 depolarization-activated potassium channel that functioned as a hyperpolarization-activated nonselective channel in guinea pigs. They demonstrate spontaneous electrical activity after transfection into the heart both in vitro
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