As dabigatran becomes more widely used in AF patients, electrophysiologists are trying to figure out how to handle anticoagulation in patients taking the drug and for whom AF ablation is planned. In a new study published in the Journal of the American College of Cardiology, Dhanunjaya Lakkireddy and colleagues report on a multicenter, observational study of 290 patients…

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A NEJM editorial fellow interviews a NEJM editorialist about subclinical AF and the risk of stroke.

A new study published in the New England Journal of Medicine sheds some much-needed light on the precise role of subclinical atrial fibrillation (AF) in the prognosis and development of ischemic stroke. ASSERT (Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial) followed 2580 patients with a newly implanted pacemaker or ICD…

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The broad enthusiasm for TAVI (transcatheter aortic valve implantation) as it enters the marketplace has been partially offset by concerns about an increased risk for stroke associated with the procedure. The role of one major cause of stroke, atrial fibrillation (AF), has not been the subject of close scrutiny. Now a study from Quebec, published in…

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John Mandrola, Eric Prystowsky, and Sanjay Kaul weigh in on PALLAS and the present and future of Multaq.

After a brief announcement earlier this year that the trial had been terminated early, the full results of PALLAS  (Permanent Atrial Fibrillation Outcomes Study Using Dronedarone on Top of Standard Therapy) have now been presented at the AHA and  published simultaneously in the New England Journal of Medicine. PALLAS shows that dronedarone (Multaq, Sanofi) should not be used in patients…

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A new trial demonstrates that an investigational RF ablation system is more effective than medical management in treating persistent AF, but the trial failed to meet a key predefined safety goal. At the Venice Arrhythmias 2011 conference, Lucas Boersma presented the results of the TTOP-AF (Tailored Treatment of Persistent Atrial Fibrillation) trial, in which 210…

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The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) has recommended new restrictions on dronedarone (Multaq), Sanofi’s embattled and controversial antiarrhythmic drug. CHMP says that dronedarone should only be used for maintaining sinus rhythm in patients with paroxysmal or persistent AF after successful cardioversion. The drug should no longer be used in…

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The PALLAS trial of dronedarone (Multaq) for permanent AF has been stopped early, according to a press release issued by Sanofi. PALLAS (Permanent Atrial fibriLLAtion outcome Study using Dronedarone on top of standard therapy) was a double-blind, placebo-controlled, phase IIIb trial of dronedarone in patients with permanent AF. The company said the discontinuation of the…

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In the Women’s Health Study, which followed nearly 35,000 women for more than 15 years, mortality was significantly higher in the 1011 women who developed AF than in the women who did not, according to a report by David Conen and colleagues published in JAMA. Here are the incidence rates (per 1000 person-years of follow-up)…

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