Key result
Catheter ablation reduces AF recurrence vs AADs despite a ~2% higher serious adverse event rate.
Why the study?
The outcomes of catheter ablation and antiarrhythmic drugs as first-line treatment for paroxysmal AF remain unclear.
Does catheter ablation reduce AF recurrence and improve quality of life compared to antiarrhythmic drugs as first-line treatment in patients with symptomatic paroxysmal atrial fibrillation?
Systematic Review (n=1,145)
Does catheter ablation reduce AF recurrence and improve quality of life compared to antiarrhythmic drugs as first-line treatment in patients with symptomatic paroxysmal atrial fibrillation?
Catheter ablation as first-line therapy for symptomatic paroxysmal AF significantly reduces recurrence and improves quality of life compared to antiarrhythmic drugs.
Supports first-line catheter ablation in symptomatic paroxysmal AF; confirms reduced recurrence versus AAD across 15 studies.
Introduction: The outcomes of Catheter Ablation (CA) and antiarrhythmic drugs (AAD) as the first-line treatment of paroxysmal Atrial Fibrillation (AF) are unclear. The current systematic review reports the evidence on efficacy outcomes of Radiofrequency Ablation (RFA) versus antiarrhythmic drugs (AAD) among these patients. Methods: Three databases, including PubMed, Cochrane, and Google Scholar, were searched by three independent reviewers to identify relevant randomized control trials (RCTs). Results: A total of 1,145 patients across five studies were assessed in this systematic review. Among these patients, 577 were randomized to receive ablation, and 568 were randomized to receive AAD. The recurrence rate was significantly higher among patients who received AAD at 1-year and 2-year follow-ups. The health-related quality of life (HR-QoL) was significantly better in the patients who received ablation therapy. The incidence of serious adverse events was 14 (6.4%) in the ablation group and 9 (4.3%) in the AAD group. Conclusion: CA seems promising for managing AF in terms of any AF recurrence, hospitalization, and quality of life. There was no increase in side effects compared to AAD.
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Hassan et al. (2022) conducted a systematic review in Symptomatic Paroxysmal Atrial Fibrillation (n=1,145). Catheter Ablation vs. Antiarrhythmic drugs (AAD) was evaluated on AF recurrence. Catheter ablation significantly reduced AF recurrence at 1 and 2 years compared to antiarrhythmic drugs, with serious adverse events occurring in 6.4% of ablation patients versus 4.3% for AAD.
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