Catheter ablation as first-line therapy for atrial fibrillation was associated with a higher long-term multiple procedure success rate compared to ablation after AAD failure (78% vs. 64%, P=0.03).
Cohort (n=434)
No
Tasa de eventos absoluta: 78% vs 64%
valor p: p=0.03
AIMS: The aims of the study were (i) to assess the characteristics of patients selected for atrial fibrillation (AF) ablation as first-line therapy, (ii) to identify current clinical criteria for such a strategy, and (iii) to analyse the outcome compared with patients who had failure of antiarrhythmic drug (AAD) therapy prior to ablation. METHODS AND RESULTS: Consecutive patients undergoing ablation of AF were included in a prospective registry. Serial long-term electrocardiogram monitoring and clinical follow-up were performed after 3, 6, and 12 months. Out of 434 patients, 17% underwent AF catheter ablation as first-line therapy (AAD-), and 83% had undergone at least one AAD trial (AAD+). In AAD- patients, the reasons for this strategy were: (i) patient preference, n= 51 (71%); (ii) contra-indication to AAD, n= 21 (29%). Atrial fibrillation duration prior to ablation was shorter (52 ± 54 vs. 78 ± 81 months, P= 0.005), and the percentage of patients hospitalized for AF (32% vs. 48%, P= 0.01) was lower in AAD- patients. Long-term multiple procedure success rate (78% vs. 64%, P= 0.03) was higher in the AAD- group, and there were less repeat ablations in this group (21% vs. 38%, P= 0.01). CONCLUSION: Catheter ablation was first-line therapy of AF in a significant number of patients, according either to patient preference or to medical factors, and this had important implications. Ablative therapy was performed at an earlier stage of the disease, and was associated with a significantly higher success rate and with a decreased need for repeat procedures.
Tanner et al. (Mon,) conducted a cohort in Atrial fibrillation (n=434). Catheter ablation as first-line therapy vs. Catheter ablation after antiarrhythmic drug failure was evaluated on Long-term multiple procedure success rate (p=0.03). Catheter ablation as first-line therapy for atrial fibrillation was associated with a higher long-term multiple procedure success rate compared to ablation after AAD failure (78% vs. 64%, P=0.03).