Ablation May Be First-Line Option for Atrial Fibrillation
(HealthDay News) — Radiofrequency ablation is more effective than medications in treating previously untreated paroxysmal atrial fibrillation, suggesting that ablation may be considered as a first-line treatment, according to a study published in the February 19 issue of the Journal of the American Medical Association.
Carlos A. Morillo, MD, from McMaster University in Hamilton, Canada, and colleagues randomly assigned 127 treatment-naive patients with paroxysmal atrial fibrillation to antiarrhythmic therapy or radiofrequency ablation.
After 24 months of follow-up, the researchers found that a significantly lower percentage of patients in the ablation group had a first recurrence of any atrial tachyarrhythmia lasting longer than 30 seconds (54.5 vs. 72.1%; hazard ratio, 0.56). The ablation group also had a significantly lower percentage of patients with symptomatic recurrence of atrial tachyarrhythmia (47 versus 59%; hazard ratio, 0.56). While there were no deaths or strokes in either group, there were four cases of cardiac tamponade in the ablation group. Quality of life improved at one year in both groups to a similar extent.
"Among patients with paroxysmal atrial fibrillation without previous antiarrhythmic drug treatment, radiofrequency ablation compared with antiarrhythmic drugs resulted in a lower rate of recurrent atrial tachyarrhythmias at two years," Morillo and colleagues conclude.
The study was funded in part by BiosenseWebster. Several authors disclosed financial ties to pharmaceutical and medical device companies.