Circumferential @entity358 for chronic XXXX .

@entity1 @entity2643 @entity358 @entity956 @entity955
BACKGROUND: We conducted a randomized, controlled trial of circumferential @entity358 for the treatment of chronic @entity955 . METHODS: A total of 146 @entity1 with a mean (+/-SD) age of 57+/-9 years who had chronic @entity955 were randomly assigned to receive @entity2643 and undergo two cardioversions during the first three months alone (the control group) or in combination with circumferential @entity358 . Cardiac rhythm was assessed with daily telephonic transmissions for one year. The left atrial diameter and the severity of symptoms were assessed at 12 months. RESULTS: Among the 77 @entity1 assigned to undergo circumferential @entity358 , ablation was repeated because of recurrent @entity955 in 26 percent of @entity1 and atypical @entity956 in 6 percent. An intention-to-treat analysis showed that 74 percent of @entity1 in the ablation group and 58 percent of those in the control group were free of recurrent @entity955 or flutter without antiarrhythmic-drug therapy at one year (P=0.05). Among the 69 @entity1 in the control group, 53 (77 percent) crossed over to undergo circumferential @entity358 for recurrent @entity955 by one year and only 3 (4 percent) were in sinus rhythm without antiarrhythmic-drug therapy or ablation. There were significant decreases in the left atrial diameter (12+/-11 percent, P<0.001) and the symptom severity score (59+/-21 percent, P<0.001) among @entity1 who remained in sinus rhythm after circumferential @entity358 . Except for atypical @entity956 , there were no complications attributable to circumferential @entity358 . CONCLUSIONS: Sinus rhythm can be maintained long term in the majority of @entity1 with chronic @entity955 by means of circumferential @entity358 independently of the effects of antiarrhythmic-drug therapy, cardioversion, or both. The maintenance of sinus rhythm is associated with a significant decrease in both the severity of symptoms and the left atrial diameter.
