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British Cardiovascular Society 2015

I have just returned from the British Cardiovascular Society (BCS) annual conference in Manchester. I was asked to present the findings of a multi-centre randomised controlled study on catheter ablation of persistent atrial fibrillation in the patients with heart failure, the AATAC-AF study.

In this study, 203 patients with AF and heart failure who took part were randomly assigned either to receive the drug amiodarone or to undergo catheter ablation of atrial fibrillation.

The key findings were that:

(i) 70% of those who had catheter ablation were free of AF during follow-up of 2 years compared to only 34% of those who received drug therapy alone.

(ii) The number of people who were hospitalised or died during the 2 year follow-up period was lower in the catheter ablation group, compared to those who had drug treatment with amiodarone.

(iii) Freedom from atrial fibrillation was associated with greater improvements in quality of life, exercise capacity and pumping function of the heart.

This study is the second randomised study in this patient population to show benefits of catheter ablation but has yet to be published so we await more details in due course…..

Several other ground-breaking studies were presented in the same session:

1) The “CRYSTAL AF” study, which showed that in patients who have had a stroke without a clear cause, the pick-up rate of atrial fibrillation was increased using an implantable loop recorder, compared to standard treatment (see original article).

2) The “PARADIGM-HF” study, which showed clear benefits of a new class of drug (as yet known as LCZ696) for the treatment of patients with heart failure, when compared to a well established treatment, enalapril (see original article).

3) The OSLER study, which showed that the monoclonal antibody evolocumab reduced LDL cholesterol over and above standard therapy by over 60%, a finding which was associated with a reduction in cardiovascular events. This is the first application of a drug of this type in the field of lipid lowering drugs, and an exciting finding, but warrants a great deal of further research (see original article).