{"id":2826,"date":"2022-12-15T15:31:42","date_gmt":"2022-12-15T14:31:42","guid":{"rendered":"https:\/\/rythmologie.fr\/?p=2826"},"modified":"2022-12-15T15:31:42","modified_gmt":"2022-12-15T14:31:42","slug":"newsletter-decembre-2022-the-progressive-af-study","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/newsletter-decembre-2022-the-progressive-af-study\/","title":{"rendered":" Newsletter D\u00e9cembre 2022 &#8211; THE ..."},"content":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}&#8221;]<div id=\"ultimate-heading-95706a076b7e12e72\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-95706a076b7e12e72 uvc-1062  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"center\" style=\"text-align:center\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-95706a076b7e12e72 h2'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}' ><h2 style=\"--font-weight:theme;margin-top:20px;margin-bottom:20px;\">Newsletter Groupe Rythmologie \u2013 Stimulation cardiaque de la SFC<\/h2><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-95706a076b7e12e72 .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;margin-top:20px;margin-bottom:20px;\">D\u00e9cembre 2022<\/div><\/div>[vc_empty_space height=&#8221;24px&#8221;][vc_separator color=&#8221;custom&#8221; accent_color=&#8221;#e42925&#8243;][\/vc_column][\/vc_row][vc_row][vc_column]<div id=\"ultimate-heading-76306a076b7e12ecb\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-76306a076b7e12ecb uvc-3827 \" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-76306a076b7e12ecb h3'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"desktop:24px;\"}' ><h3 style=\"--font-weight:theme;color:#e42925;margin-top:24px;margin-bottom:24px;\">Best of rythmologie AHA - THE PROGRESSIVE-AF STUDY<\/h3><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-76306a076b7e12ecb .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;color:#000000;margin-top:24px;margin-bottom:24px;\"><i><span style=\"font-weight: 400;\">Auteurs : Eloi Marijon et Fawzi Kerkour &#8211; CHU Pompidou Paris\u00a0<\/span><\/i><\/div><\/div>[vc_empty_space height=&#8221;24px&#8221;][vc_column_text]<\/p>\n<p style=\"text-align: justify;\"><b>Atrial Fibrillation Progression After Cryoablation versus Drug Therapy\u00a0<\/b><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Mots cl\u00e9s : fibrillation atriale (FA) ; traitement antiarythmique (TAA) ; cryoablation ; paroxystique ;\u00a0 symptomatique.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><b>Rationnel de l\u2019\u00e9tude\u00a0<\/b><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">L&#8217;ablation de la FA est sup\u00e9rieure au TAA pour maintenir le rythme sinusal et am\u00e9liorer la qualit\u00e9 de vie\u00a0 des patients.<\/span><span style=\"font-weight: 400;\">1,2,3 <\/span><span style=\"font-weight: 400;\">En quelle mesure la cryoablation pr\u00e9coce de FA limite la progression vers la persistance\u00a0 du trouble du rythme ? Cette question n\u2019a pas \u00e9t\u00e9 \u00e9tudi\u00e9.<\/span><span style=\"font-weight: 400;\">4,5,6<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><b>Quel est l\u2019objectif de l\u2019\u00e9tude ?\u00a0<\/b><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">L&#8217;objectif de PROGRESSIVE-AF \u00e9tait d&#8217;\u00e9valuer l\u2019int\u00e9r\u00eat de la cryoablation en 1<\/span><span style=\"font-weight: 400;\">\u00e8re <\/span><span style=\"font-weight: 400;\">intention en termes de\u00a0 r\u00e9duction du passage du mode paroxystique au mode persistant, compar\u00e9 au TAA, chez des patients\u00a0 implant\u00e9s d\u2019un moniteur sous-cutan\u00e9.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Le crit\u00e8re d&#8217;\u00e9valuation principal \u00e9tait la premi\u00e8re r\u00e9cidive de tachyarythmie atriale (fibrillation atriale, flutter\u00a0 atrial ou tachycardie) \u00e0 partir de la fin du 3\u00e8me mois (p\u00e9riode de <\/span><i><span style=\"font-weight: 400;\">blanking<\/span><\/i><span style=\"font-weight: 400;\">). Les crit\u00e8res d&#8217;\u00e9valuation\u00a0 secondaires comprenaient l&#8217;absence de sympt\u00f4mes d\u2019arythmie, la charge totale en FA et la qualit\u00e9 de\u00a0 vie.<\/span><span style=\"font-weight: 400;\">7<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p>[\/vc_column_text][vc_empty_space height=&#8221;24px&#8221;][vc_row_inner][vc_column_inner][vc_column_text]<b>THE PROGRESSIVE-AF STUDY est une extension d\u2019\u00e9tude EARLY-AF\u00a0<\/b>[\/vc_column_text][vc_single_image image=&#8221;2829&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][\/vc_row_inner][vc_column_text]<span style=\"font-weight: 400;\">Les deux bras poss\u00e8dent des caract\u00e9ristiques similaires avec une population jeune et peu de\u00a0 comorbidit\u00e9s.<\/span>[\/vc_column_text][vc_empty_space height=&#8221;24px&#8221;][vc_row_inner][vc_column_inner][vc_column_text]<b>Quelles sont les principales conclusions ?\u00a0<\/b>[\/vc_column_text]<div id=\"ultimate-heading-13836a076b7e12f0b\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-13836a076b7e12f0b uvc-3303 \" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-13836a076b7e12f0b .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;color:#e42925;margin-top:24px;margin-bottom:24px;\"><span style=\"font-weight: 400;\">Reduction de 75 % de progression vers une FA persistante<\/span><\/div><\/div>[vc_single_image image=&#8221;2830&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221;][\/vc_column_inner][\/vc_row_inner][vc_column_text]<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">En pr\u00e9sentant les r\u00e9sultats au congr\u00e8s de l\u2019AHA 2022, Jason G. Andrade, MD, a not\u00e9 que lors d&#8217;un suivi\u00a0 \u00e0 long terme, l&#8217;ablation de premi\u00e8re ligne \u00e9tait \u00e9galement associ\u00e9e \u00e0 :\u00a0<\/span><\/p>\n<p>[\/vc_column_text]<div id=\"ultimate-heading-89476a076b7e12f44\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-89476a076b7e12f44 uvc-8334 \" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-89476a076b7e12f44 .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;color:#e42925;margin-top:24px;margin-bottom:24px;\"><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">R\u00e9duction significative de toute r\u00e9cidive d&#8217;arythmie\u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Charge significativement plus faible de la fibrillation atriale\u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Am\u00e9lioration significative de la qualit\u00e9 de vie\u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Taux inf\u00e9rieur d&#8217;utilisation des soins de sant\u00e9 (hospitalisation, recours aux <\/span>urgences, cardioversion, ablation)<\/li>\n<li>Taux similaire ou inf\u00e9rieur d&#8217;\u00e9v\u00e9nements ind\u00e9sirables1<\/li>\n<\/ul>\n<p><\/div><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: justify;\"><b>Sur la base de ces r\u00e9sultats, quel impact cette \u00e9tude devrait-elle avoir sur la pratique ?\u00a0<\/b><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-weight: 400;\">Malgr\u00e9 42 % de crossover (vers le groupe cryoablation) \u00e0 3 ans, l\u2019analyse en intention de traitement\u00a0 confirme le b\u00e9n\u00e9fice de la cryoablation \u00e0 r\u00e9duire la progression de la FA. Ces r\u00e9sultats pourraient participer \u00e0 renforcer encore plus l\u2019ablation pr\u00e9coce de FA en 1\u00e8re intention lors des prochaines guidelines. <\/span><\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space]<div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-large \" href=\"https:\/\/www.sfcardio.fr\/sites\/default\/files\/2022-12\/Newsletter-Rythmo-1222_0.pdf?utm_source=sendinblue&utm_campaign=Groupe%20Rythmologie%20-%20Stimulation%20cardiaque%20%20Dcembre%202022&utm_medium=email\" target=\"_blank\" rel=\"nofollow  noopener\" ><button type=\"button\" id=\"ubtn-7853\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-large ubtn-no-hover-bg  none  ubtn-center   tooltip-6a076b7e12f7e\"  data-hover=\"#e42925\" data-border-color=\"\" data-bg=\"rgba(0,0,0,0.1)\" data-hover-bg=\"#ffffff\" data-border-hover=\"\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-7853'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-family:&#039;Montserrat&#039;;font-weight:800;border:none;background: rgba(0,0,0,0.1);color: #000000;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >T\u00e9l\u00e9charger toute la newsletter<\/span><\/button><\/a><\/div>[vc_empty_space][vc_separator][vc_empty_space][vc_column_text]<\/p>\n<p style=\"text-align: justify;\"><strong>R\u00e9f\u00e9rences :\u00a0<\/strong><\/p>\n<p style=\"text-align: justify;\">1 Packer DL, Kowal RC, Wheelan KR, Irwin JM, Champagne J, Guerra PG, et al. Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol. 2013;61:1713\u201123.<\/p>\n<p style=\"text-align: justify;\">2 Farkowski MM. [Commentary to the article: Wilber DJ, Pappone C, Neuzil P et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA, 2010; 303: 333-340]. Kardiol Pol. mai 2010;68(5):609\u201111; discussion 612-613.<\/p>\n<p style=\"text-align: justify;\">3 Jg A, L M, A V, Mw D, J C, M D, et al. Quality of Life and Health Care Utilization in the CIRCA-DOSE Study. JACC Clinical electrophysiology [Internet]. ao\u00fbt 2020 [cit\u00e9 3 d\u00e9c 2022];6(8). Disponible sur: https:\/\/pubmed.ncbi.nlm.nih.gov\/32819528<\/p>\n<p style=\"text-align: justify;\">4 Cosedis Nielsen J, Johannessen A, Raatikainen P, Hindricks G, Walfridsson H, Kongstad O, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation. N Engl J Med. 2012;367:1587\u201195.<\/p>\n<p style=\"text-align: justify;\">5 Morillo CA, Verma A, Connolly SJ, Kuck KH, Nair GM, Champagne J, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial. JAMA. 2014;311:692\u2011700.<\/p>\n<p style=\"text-align: justify;\">6 Wazni OM, Marrouche NF, Martin DO, Verma A, Bhargava M, Saliba W, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA. 2005;293(21):2634\u201140.<\/p>\n<p style=\"text-align: justify;\">7 Andrade JG, Deyell MW, Macle L, Wells GA, Bennett M, Essebag V, et al. Progression of Atrial Fibrillation after Cryoablation or Drug Therapy. N Engl J Med. 7 nov 2022; in press<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}&#8221;][vc_empty_space height=&#8221;24px&#8221;][vc_separator color=&#8221;custom&#8221; accent_color=&#8221;#e42925&#8243;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=&#8221;24px&#8221;][vc_column_text] Atrial Fibrillation Progression After Cryoablation versus Drug Therapy\u00a0 Mots cl\u00e9s : fibrillation atriale (FA) ; traitement antiarythmique (TAA) ; cryoablation ; paroxystique ;\u00a0 symptomatique.\u00a0 &nbsp; Rationnel de l\u2019\u00e9tude\u00a0 L&#8217;ablation de la FA est sup\u00e9rieure au TAA pour maintenir le rythme sinusal&hellip;<\/p>\n","protected":false},"author":2,"featured_media":2828,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[31,22],"tags":[],"class_list":["post-2826","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","category-articles","category-31","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=2826"}],"version-history":[{"count":3,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2826\/revisions"}],"predecessor-version":[{"id":2839,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2826\/revisions\/2839"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/2828"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=2826"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=2826"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=2826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}