Why the study?
Antiarrhythmic drugs have limited success for rhythm control in AF due to side effects and proarrhythmia, while catheter ablation techniques need further improvement for persistent forms of AF.
Catheter ablation is highlighted as a potentially superior alternative to antiarrhythmic drugs for rhythm control in paroxysmal atrial fibrillation.
May support ablation over drugs for paroxysmal AF rhythm control; leaves open need for confirmatory RCTs before practice change.
Atrial fibrillation (AF), the most common arrhythmia encountered worldwide, is associated with significant morbidity. The three important considerations with regard to AF management are stroke prevention, rate control, and rhythm control, with the latter two overlapping to some extent. While antiarrhythmic drugs have had limited success as a rhythm control strategy, being limited by side effects and proarrhythmia, catheter ablation has emerged as a potentially better alternative. Current ablation techniques afford good success for paroxysmal AF, especially when done in experienced centers; however, further improvements and innovations are required to improve results for more persistent forms of AF. The current review critically summarizes the present strategies employed for rhythm control in AF and briefly outlines some of the newer developments in this field.
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Kumar Narayanan (2020) studied this question.
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