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Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin
Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan
Coordinator for the
Board of Directors
Dr. Can Yücel Karabay
Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı
Bulletin Preparation
Göksel Çinier
Ali Nazmi Çalık
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EHRA 2019Türk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - EHRA 2019 ()
- CIRCA-DOSE Trial
Dr. Jason Andrade from Canada presented their results from CIRCA-DOSE. In randomised clinical trial researchers evaluated the safety and efficacy of second-generation cryoablation versus contact-force irrigated radiofrequency catheter ablation (CF-RF) for atrial fibrillation, as well as double short (2-minute) (Cryo-2) versus standard (4-minute) (Cryo-4) cryoapplication exposure.
The major strength of the study was that all study population had long-term rhythm monitoring by REVEAL-LINQ devices which were implanted several weeks to months prior to ablation procedure. This allowed evaluating the baseline AF burden of patients.
The primary endpoint was any atrial tachyarrhythmia detected by any means from 91-365 days following ablation. The secondary endpoints included symptomatic AF/AT/AFL and re-ablation at any time.
Baseline characteristics of patients were similar between groups and reflected of a typical paroxysmal AF patient (mostly male, in late 50’s, low stroke risk) but they were very symptomatic (median 4 AF episodes per month).
Primary outcome did not differ between CF-RF (53.9%), Cryo-2 (51.7%) and Cryo-4 (52.2%) groups. Freedom from any symptomatic AF/AT/AFL did not differ between groups (CF-RF (79.1%), Cryo-2 (73.3%) and Cryo-4 (79.1%).
The most striking result was that no matter which strategy is used (CF-RF, Cryo-2 or Cryo-4) AF burden was reduced dramatically (98%-99%).
https://cardiacrhythmnews.com/circa-dose-trial-results-ehra-2019/
- ELIMINATE-AF Trial
This blinded, prospective, randomized, open-label, phase 3b trial was designed to compare the efficacy and safety of uninterrupted edoxaban treatment with uninterrupted warfarin treatment during the catheter ablation for atrial fibrillation.
Patients in the study (n = 560) were randomized 2:1 to edoxaban 60 mg daily (or 30 mg according to dose-reduction criteria) or to coumadin, respectively, for at least 21 days. They then underwent transesophageal echocardiography, catheter ablation, and MRI and were followed for a 90-day treatment period and 30 days of follow-up. Primary composite end-point included all-cause mortality, any form of stroke and any major bleeding assessed by ISTH definition.
Per protocol analysis showed the composite end point was achieved by 1.3% of the edoxaban group and 3.0% of the VKA group (hazard ratio, 0.42; 95% CI, 0.096 - 1.885; P = .26). In a modified intention-to-treat analysis in which only patients who had actually undergone ablation were included, the rates were 2.7% and 1.7%, respectively, and also not statistically significant.
ISTH major bleeding events occurred at an incidence of 2.5% on edoxaban and 1.5% on VKA without any statistical significant difference between the two groups,
- RACE 7- ACWAS Trial
Majority of patients with recent-onset symptomatic atrial fibrillation undergo immediate restoration of sinus rhythm with either pharmacological or electrical cardioversion (CV). However, it is not known whether restoration of sinus rhythm is necessary since most of these episodes terminate spontaneously.
This multicenter, randomized, open label, non-inferiority trial evaluated whether wait-and-see approach which included administration of rate-control drugs and delayed CV (within 48h after the symptom onset) if necessary, was non-inferior to early CV for obtaining sinus rhythm.
Patients that presented to emergency department with hemodynamically stable, symptomatic, recent-onset (<36h) without signs of myocardial ischemia or a history of persistent AF were included to the study. Transesophageal was not performed in any patient and anticoagulation was administered according to the stroke risk of patients and current guidelines. The primary endpoint was the presence of sinus rhythm at 4 weeks.
218 patients were assigned to delayed-CV and 219 were assigned to early-CV groups. 40% of patients were female and more than half of patients had CHADs-VASc score of more than 2. In the wait-and-see group 69% of patients returned to sinus rhythm spontaneously within 48h. At 4 weeks 91% and 94% of patients were in sinus rhythm in wait-and-see and early-CV groups respectively (between-group difference, -2.9 percentage points; 95% confidence interval [CI], -8.2 to 2.2; P=0.005 for non-inferiority).
10 cardiovascular complications occurred in the delayed-cardioversion group (including 1 patient with ischemic stroke and 3 with acute coronary syndrome or unstable angina) and 8 in the early-cardioversion group (including 1 patient with transient ischemic attack and 3 with acute coronary syndrome or unstable angina). There were no deaths during follow-up.
https://www.nejm.org/doi/10.1056/NEJMoa1900353
https://www.medscape.com/viewarticle/910662#vp_2
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