{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T19:29:51Z","timestamp":1773948591741,"version":"3.50.1"},"reference-count":30,"publisher":"Sociedade Brasileira de Cardiologia","issue":"6","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  N\u00e3o existem estudos randomizados comparando a manuten\u00e7\u00e3o do ritmo sinusal ap\u00f3s abla\u00e7\u00e3o por cateter (AC) em rela\u00e7\u00e3o ao tratamento com f\u00e1rmacos antiarr\u00edtmicos (AA) em pacientes idosos portadores fibrila\u00e7\u00e3o atrial (FA) parox\u00edstica.  Objetivos  Comparar os resultados cl\u00ednicos do isolamento das veias pulmonares (VPs) com o cateter PVAC Gold de segunda gera\u00e7\u00e3o com o uso de AA em idosos com FA parox\u00edstica sintom\u00e1tica, recorrente, apesar do uso de f\u00e1rmacos AA.  M\u00e9todos  Sessenta pacientes com FA parox\u00edstica \u2265 65 anos e sem cardiopatias estruturais foram randomizados para duas formas de tratamento: grupo 1: AC e grupo 2: AA. O desfecho prim\u00e1rio foi a taxa livre de recorr\u00eancia de FA ap\u00f3s pelo menos um ano de seguimento. Os desfechos secund\u00e1rios foram: progress\u00e3o para formas persistentes de FA, impacto na qualidade de vida (QVFA) e complica\u00e7\u00f5es. O n\u00edvel de signific\u00e2ncia adotado na an\u00e1lise estat\u00edstica foi de 5% (p&lt;0,05).  Resultados  A taxa livre de recorr\u00eancia de FA foi de 80% (10% com amiodarona) no grupo AC, ap\u00f3s 1,3 procedimentos por paciente e de 65% no grupo AA (60% com amiodarona), (p = 0,119) num seguimento m\u00e9dio de 719 dias (Q1: 566; Q3: 730). A taxa livre de FA persistente foi de 83,4% no grupo AC e de 67,7% no grupo AA (p = 0,073). Ambas as estrat\u00e9gias apresentaram melhora no escore de QVFA durante o seguimento (p &lt; 0,001), sem diferen\u00e7a entre os grupos. Embora sem repercuss\u00e3o cl\u00ednica ou impacto no teste de avalia\u00e7\u00e3o intelectual, 25% dos pacientes do grupo PVAC apresentou sinais de emboliza\u00e7\u00e3o cerebral na RNM cerebral.  Conclus\u00f5es  Ambas as estrat\u00e9gias para manuten\u00e7\u00e3o do ritmo sinusal promoveram melhora na qualidade de vida de pacientes idosos com FA sintom\u00e1tica, sem diferen\u00e7a estat\u00edstica nos desfechos cl\u00ednicos preconizados. Estudos adicionais usando tecnologias com melhor perfil de seguran\u00e7a s\u00e3o necess\u00e1rios para avaliar os benef\u00edcios da AC em pacientes idosos com FA.<\/jats:p>","DOI":"10.36660\/abc.20230684","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T13:30:33Z","timestamp":1724938233000},"source":"Crossref","is-referenced-by-count":4,"title":["Estudo Randomizado Comparando a Abla\u00e7\u00e3o por Cateter com o PVAC Gold vs. Tratamento com F\u00e1rmacos Antiarr\u00edtmicos em Pacientes Idosos com Fibrila\u00e7\u00e3o Atrial Sintom\u00e1tica"],"prefix":"10.36660","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4969-857X","authenticated-orcid":false,"given":"Luiz Claudio Berhmann","family":"Martins","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano F.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio K.","family":"Dorfman","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco C. C.","family":"Darrieux","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tan C.","family":"Wu","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto P.","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise T.","family":"Hachul","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio Campi de","family":"Castro","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rog\u00e9rio Ruscitto do","family":"Prado","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9746-0892","authenticated-orcid":false,"given":"Luciana V. F.","family":"Souza","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana","family":"Sacilloto","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9831-3392","authenticated-orcid":false,"given":"Gabrielle D. A.","family":"Pessente","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar J.","family":"Grupi","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhieddine Omar","family":"Chokr","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar H.","family":"Nomura","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e1tia Rodrigues de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-6549","authenticated-orcid":false,"given":"Conrado P.","family":"Balbo","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sissy L.","family":"Melo","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Veronese","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7327-2275","authenticated-orcid":false,"given":"Mauricio I.","family":"Scanavacca","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2024]]},"reference":[{"issue":"5","key":"ref1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation Developed in Collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks G","year":"2021","journal-title":"Eur Heart J"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1161\/CIR.0000000000000665","article-title":"2019 AHA\/ACC\/HRS Focused Update of the 2014 AHA\/ACC\/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons","volume":"140","author":"January CT","year":"2019","journal-title":"Circulation"},{"issue":"9","key":"ref3","article-title":"Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Asad ZUA","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"6","key":"ref4","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1093\/europace\/euaa042","article-title":"Paroxysmal and Persistent Atrial Fibrillation Ablation Outcomes with the Pulmonary Vein Ablation Catheter GOLD Duty-cycled Phased Radiofrequency Ablation Catheter: Quality of Life and 12-month Efficacy Results from the GOLD Atrial Fibrillation Registry","volume":"22","author":"Boersma L","year":"2020","journal-title":"Europace"},{"issue":"7","key":"ref5","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/pace.13737","article-title":"Comparison of Efficacy of Phased Multipolar Versus Traditional Radiofrequency Ablation: A Prospective, Multicenter Study (CAPCOST)","volume":"42","author":"Essebag V","year":"2019","journal-title":"Pacing Clin Electrophysiol"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.ijcard.2009.03.087","article-title":"Validating a New Quality of Life Questionnaire for Atrial Fibrillation Patients","volume":"143","author":"Braganca EO","year":"2010","journal-title":"Int J Cardiol"},{"issue":"3","key":"ref7","first-page":"189","article-title":"\"Mini-mental State\". A Practical Method for Grading the Cognitive State of Patients for the Clinician","volume":"12","author":"Folstein MF","year":"1975","journal-title":"J Psychiatr Res"},{"issue":"17","key":"ref8","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1161\/CIRCULATIONAHA.110.937953","article-title":"Radiofrequency Catheter Ablation of Atrial Fibrillation: A Cause of Silent Thromboembolism? Magnetic Resonance Imaging Assessment of Cerebral Thromboembolism in Patients Undergoing Ablation of Atrial Fibrillation","volume":"122","author":"Gaita F","year":"2010","journal-title":"Circulation"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.hrthm.2018.09.027","article-title":"Temporal Relationships between Esophageal Injury Type and Progression in Patients Undergoing Atrial Fibrillation Catheter Ablation","volume":"16","author":"Yarlagadda B","year":"2019","journal-title":"Heart Rhythm"},{"issue":"13","key":"ref10","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1056\/NEJM200003303421302","article-title":"Amiodarone to Prevent Recurrence of Atrial Fibrillation. Canadian Trial of Atrial Fibrillation Investigators","volume":"342","author":"Roy D","year":"2000","journal-title":"N Engl J Med"},{"issue":"14","key":"ref11","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early Rhythm-Control Therapy in Patients with Atrial Fibrillation","volume":"383","author":"Kirchhof P","year":"2020","journal-title":"N Engl J Med"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1161\/CIRCULATIONAHA.121.055297","article-title":"Association between Age and Outcomes of Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: Results From the CABANA Trial","volume":"145","author":"Bahnson TD","year":"2022","journal-title":"Circulation"},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s10840-014-9945-4","article-title":"Catheter Ablation Versus Anti-arrhythmic Drug Therapy for the Management of Atrial fibrillation: A Meta-analysis","volume":"41","author":"Cheng X","year":"2014","journal-title":"J Interv Card Electrophysiol"},{"issue":"13","key":"ref14","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1056\/NEJM200003303421302","article-title":"Amiodarone to Prevent Recurrence of Atrial Fibrillation. Canadian Trial of Atrial Fibrillation Investigators","volume":"342","author":"Roy D","year":"2000","journal-title":"N Engl J Med"},{"issue":"3","key":"ref15","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3724\/SP.J.1263.2011.00184","article-title":"Use of Antiarrhythmic Drugs in Elderly Patients","volume":"8","author":"Lee HC","year":"2011","journal-title":"J Geriatr Cardiol"},{"issue":"6","key":"ref16","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jacc.2013.03.073","article-title":"Subtle Post-procedural Cognitive Dysfunction After Atrial Fibrillation Ablation","volume":"62","author":"Medi C","year":"2013","journal-title":"J Am Coll Cardiol"},{"issue":"8","key":"ref17","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1093\/europace\/euac003","article-title":"Predictive Role of Atrial Fibrillation in Cognitive Decline: A Systematic Review and Meta-analysis of 2.8 Million Individuals","volume":"24","author":"Koh YH","year":"2022","journal-title":"Europace"},{"issue":"5","key":"ref18","article-title":"Silent Cerebral Events after Atrial Fibrillation Ablation - Overview and Current Data","volume":"6","author":"Deneke T","year":"2014","journal-title":"J Atr Fibrillation"},{"issue":"5","key":"ref19","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1093\/europace\/euv385","article-title":"Low Rate of Asymptomatic Cerebral Embolism and Improved Procedural Efficiency with the Novel Pulmonary Vein Ablation Catheter GOLD: Results of the PRECISION GOLD Trial","volume":"18","author":"De Greef Y","year":"2016","journal-title":"Europace"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jacep.2018.11.008","article-title":"Incidence and Clinical Significance of Cerebral Embolism During Atrial Fibrillation Ablation With Duty-Cycled Phased-Radiofrequency Versus Cooled-Radiofrequency: A Randomized Controlled Trial","volume":"5","author":"Ke\u00e7e F","year":"2019","journal-title":"JACC Clin Electrophysiol"},{"issue":"2","key":"ref21","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jacep.2021.12.012","article-title":"Cerebral Embolism During Catheter Ablation of Atrial Fibrillation Using Radiofrequency Catheter, Cryoballoon, Hotballoon, or Laserballoon","volume":"8","author":"Tokuda M","year":"2022","journal-title":"JACC Clin Electrophysiol"},{"issue":"5","key":"ref22","first-page":"354","article-title":"Current Atrial Fibrillation Ablation: An Alert for the Prevention and Treatment of Esophageal Lesions","volume":"106","author":"Scanavacca M","year":"2016","journal-title":"Arq Bras Cardiol"},{"issue":"11","key":"ref23","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1111\/jce.14193","article-title":"Incidence of Acute Thermal Esophageal Injury After Atrial Fibrillation Ablation Guided by Prespecified Ablation Index","volume":"30","author":"Halbfass P","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"issue":"3","key":"ref24","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/jce.14883","article-title":"Incidence of Ablation-induced Esophageal Injury Associated with High-power Short Duration Temperature-controlled Pulmonary Vein Isolation Using a Specialized Open-Irrigated Ablation Catheter: A Retrospective Single-center Study","volume":"32","author":"Piringer R","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"issue":"2","key":"ref25","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.112.004549","article-title":"Long-term Outcomes of Catheter Ablation of Atrial Fibrillation: A Systematic Review and Meta-analysis","volume":"2","author":"Ganesan AN","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s10840-020-00728-8","article-title":"Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation","volume":"60","author":"Klaver MN","year":"2021","journal-title":"J Interv Card Electrophysiol"},{"issue":"6","key":"ref27","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1001\/jamacardio.2021.0852","article-title":"Assessment of Catheter Ablation or Antiarrhythmic Drugs for First-line Therapy of Atrial Fibrillation: A Meta-analysis of Randomized Clinical Trials","volume":"6","author":"Turagam MK","year":"2021","journal-title":"JAMA Cardiol"},{"issue":"1","key":"ref28","first-page":"87","article-title":"Catheter Ablation is Superior to Antiarrhythmic Drugs as First-Line Treatment for Atrial Fibrillation: A Systematic Review and Meta-Analysis","volume":"119","author":"Cardoso R","year":"2022","journal-title":"Arq Bras Cardiol"},{"issue":"9","key":"ref29","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad244","article-title":"Progress in Atrial Fibrillation Ablation During 25 Years of Europace Journal","volume":"25","author":"Boersma L","year":"2023","journal-title":"Europace"},{"issue":"12","key":"ref30","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1093\/europace\/euab168","article-title":"Efficacy and Safety of the GOLD FORCE Multicentre Randomized Clinical Trial: Multielectrode Phased Radiofrequency vs. Irrigated Radiofrequency Single-tip Catheter with Contact Force Ablation for Treatment of Symptomatic Paroxysmal Atrial Fibrillation","volume":"23","author":"Wintgens LIS","year":"2021","journal-title":"Europace"}],"container-title":["Arquivos Brasileiros de Cardiologia"],"original-title":["Randomized Study Comparing Radiofrequency Ablation with the PVAC Gold System vs. Antiarrhythmic Drugs in Elderly Patients with Symptomatic Atrial Fibrillation"],"link":[{"URL":"https:\/\/abccardiol.org\/wp-content\/uploads\/articles_xml\/0066-782X-abc-121-6-e20230684\/0066-782X-abc-121-6-e20230684.x47225.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T13:30:52Z","timestamp":1724938252000},"score":1,"resource":{"primary":{"URL":"https:\/\/abccardiol.org\/article\/estudo-randomizado-comparando-a-ablacao-por-cateter-com-o-pvac-gold-vs-tratamento-com-farmacos-antiarritmicos-em-pacientes-idosos-com-fibrilacao-atrial-sintomatica\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024]]}},"alternative-id":["S0066-782X2024000600308"],"URL":"https:\/\/doi.org\/10.36660\/abc.20230684","relation":{"is-translation-of":[{"id-type":"doi","id":"10.36660\/abc.20230684i","asserted-by":"subject"},{"id-type":"doi","id":"10.36660\/abc.20230684i","asserted-by":"object"}]},"ISSN":["1678-4170","0066-782X"],"issn-type":[{"value":"1678-4170","type":"electronic"},{"value":"0066-782X","type":"print"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e20230684"}}