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Цитата:
Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction (CAMERA-MRI). J Am Coll Cardiol 2017;Aug 27
Conclusions:
In a population of patients with idiopathic cardiomyopathy, restoration of sinus rhythm with catheter ablation results in significant improvements in LV function, particularly in the absence of ventricular fibrosis on CMR.
Perspective:
In patients with cardiomyopathy, prior studies of rhythm control with antiarrhythmic medications had disappointing results. A few studies of catheter ablation in various AF types and cardiomyopathy populations have shown benefits in patients in whom sinus rhythm is maintained after AF ablation. The present study confirms many of those findings in a population of patients with persistent AF and idiopathic cardiomyopathy, especially in patients who do not have late gadolinium enhancement on MRI. The current study supports the notion that rhythm strategy with ablation should be pursued despite the achievement of good rate control. It just so happens that another study, involving patients with paroxysmal and persistent AF, with a greater number of patients, was just presented at the the European Society of Cardiology Congress. CASTLE-AF (Catheter Ablation vs. Conventional Therapy For Patients With AF and LV Dysfunction) showed that the composite of all-cause mortality and hospitalization for worsening heart failure was significantly lower in the ablation group (28.5%) compared to the control group (44.6%) over a median follow-up period of 37.8 months.
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Контроль ритма с РЧА потихоньку побеждает контроль ЧСС при ФП.
Синусовый ритм все-таки лучше, только удерживать его нужно не ядами.