Catheter Ablation or Amiodarone: Which Has Better Outcomes in A-Fib, HF?

New research suggests that patients with heart failure and atrial fibrillation may have improved outcomes with catheter ablation compared to treatment with amiodarone. The study was presented at the American College of Cardiology’s 64th Annual Scientific Session.

Luigi Di Biase, MD, PhD, from the Albert Einstein College of Medicine at Montefiore Hospital in New York, and colleagues enrolled over 200 heart patients treated in eight European and U.S. hospitals, diagnosed with heart failure or atrial fibrillation, and had either an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy with defibrillator (CRT-D). The patients were randomly assigned to either undergo catheter ablation or treatment with amiodarone.

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Overall, the patients in the catheter ablation arm had improved outcomes during the two-year follow-up and were less likely to experience recurrent atrial fibrillation The patients receiving catheter ablation had lower rates of subsequent hospitalization compared to the amiodarone group (31% vs. 57%, respectively) and mortality (8% vs. 18%, respectively). The highest success rates were observed with procedures in which areas in addition to the pulmonary vein were ablated.

Due to the serious long-term side effects associated with amiodarone treatment, catheter ablation may be an effective and safe alternative treatment for heart failure and atrial fibrillation patients, the study authors report. Amiodarone is indicated for the treatment of documented, life-threatening recurrent refractory ventricular fibrillation or hemodynamically unstable ventricular tachycardia.

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