A Systematic Review of Randomized Trials Comparing Radiofrequency Ablation with Antiarrhythmic Medications in Patients with Atrial Fibrillation

INTRODUCTION: Atrial fibrillation (AF) is the most frequent arrhythmia seen in clinical practice. Until recently, antiarrhythmic medications have been the only commonly employed treatment for maintaining sinus rhythm. However, antiarrhythmic medications have a modest long-term efficacy and the potential for serious side effects. Radiofrequency (RF) ablation is now emerging as a viable alternative to antiarrhythmic medications in maintaining sinus rhythm in patients with AF. Several randomized trials comparing RF ablation with antiarrhythmic medications have now been published. OBJECTIVES: To perform a systematic review of published randomized trials comparing RF ablation with antiarrhythmic medications in the treatment of AF. METHODS: A systematic review of the literature was performed and two authors independently abstracted the data from trials. A statistical analysis was performed using Comprehensive Meta-Analysis Software (BIOSTAT, Englewood, NJ, USA). RESULTS: A total of six trials were identified. Overall, RF ablation reduced the risk of AF recurrence by 65% at 1 year compared with antiarrhythmic medications. CONCLUSIONS: In selected patients with AF, RF ablation reduced the risk of AF recurrence at 1 year by 65% compared with antiarrhythmic medications.