Cited by 140Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

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Results from the Loire-Ardeche-Drome-Isere-Puy-de-Dome (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter

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Da Costa, Antoine, Thévenin, Jérôme, Roche, Frédéric, Romeyer-Bouchard, Cécile, Abdellaoui, Loucif, Messier, Marc, Denis, Lucien, Faure, Emmanuel, Gonthier, Régis, Kruszynski, Georges, Pages, J. Marie, Bonijoly, Serge, Lamaison, Dominique, Defaye, Pascal, Barthélemy, J. Claude, Gouttard, Thierry, Isaaz, Karl·2006·Circulation

DOI 10.1161/circulationaha.106.638395

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Abstract

BACKGROUND: There is no published randomized study comparing amiodarone therapy and radiofrequency catheter ablation (RFA) after only 1 episode of symptomatic atrial flutter (AFL). The aim of the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) Trial of Atrial Flutter was 2-fold: (1) to prospectively compare first-line RFA (group I) versus cardioversion and amiodarone therapy (group II) after only 1 AFL episode; and (2) to determine the impact of both treatments on the long-term risk of subsequent atrial fibrillation (AF). METHODS AND RESULTS: From October 2002 to February 2006, 104 patients (aged 78+/-5 years; 20 women) with AFL were included, with 52 patients in group I and 52 patients in group II. The cumulative risk of AFL or AF was interpreted with the use of Kaplan-Meier curves and compared by the log-rank test. Clinical presentation, echocardiographic data, and follow-up were as follows: age (78.5+/-5 versus 78+/-5 years), history of AF (27% versus 21.6%); structural heart disease (58% versus 65%), left ventricular ejection fraction (56+/-14% versus 54.5+/-14%), left atrial size (43+/-7 versus 43+/-6 mm), mean follow-up (13+/-6 versus 13+/-6 months; P=NS), recurrence of AFL (3.8% versus 29.5%; P<0.0001), and occurrence of significant AF beyond 10 minutes (25% versus 18%; P=0.3). Five complications (10%) were noted in group II (sick sinus syndrome in 2, hyperthyroidism in 1, and hypothyroidism in 2) and none in group I (0%) (P=0.03). CONCLUSIONS: RFA should be considered a first-line therapy even after the first episode of symptomatic AFL. There is a better long-term success rate, the same risk of subsequent AF, and fewer secondary effects.

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Authors: Da Costa, A., Thévenin, J., Roche, F., Romeyer-Bouchard, C., Abdellaoui, L., Messier, M., Denis, L., Faure, E., Gonthier, R., Kruszynski, G., Pages, J. M., Bonijoly, S., Lamaison, D., Defaye, P., Barthélemy, J. C., Gouttard, T., & Isaaz, K.
Affiliations: From the Division of Cardiology (A.D.C., J.T., C.R.-B., K.I.), Department of Physiology (F.R., J.C.B.), University Jean Monnet in Saint-Etienne, Saint-Etienne, France; Division of Cardiology, Firminy Hospital, Firminy, France (L.A.); Bakken Research Center, Maastricht, Netherlands (M.M.); Division of Cardiology, Saint-Chamond Hospital, Saint-Chamond, France (L.D.); Division of Cardiology, Valence Hospital, Valence, France (E.F.); Department of Medicine for the Elderly, La Charité Hospital, Saint...
Université Jean Monnet (FR)
ORCID: Messier, Marc
Defaye, Pascal
Isaaz, Karl
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2006-10-17
Volume: 114
Issue: 16
Pages: 1676-1681
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.106.638395
OpenAlex: W2065695293
Cited by: 140
References: 39
Citations by year: 2026: 2 · 2025: 13 · 2024: 5 · 2023: 6 · 2022: 3 · 2021: 8 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 2 · 2016: 7 · 2015: 11 · 2014: 5 · 2013: 7 · 2012: 10
FWCI: 7.11
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: atrial flutter, radiofrequency catheter ablation, amiodarone, cardioversion, atrial fibrillation recurrence, first-line therapy, treatment complications, sick sinus syndrome, hyperthyroidism, hypothyroidism, elderly patients, structural heart disease, left atrial size, left ventricular ejection fraction
MeSH terms: Aged, Aged, 80 and over, Amiodarone, Atrial Flutter, Female, Follow-Up Studies, France, Humans, Male, Prospective Studies, Treatment Outcome, Catheter Ablation

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Results from the Loire-Ardeche-Drome-Isere-Puy-de-Dome (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter

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