Key result
First-line catheter ablation is superior to antiarrhythmic drugs in achieving freedom from atrial fibrillation or atrial tachyarrhythmia in patients with paroxysmal atrial fibrillation.
Why the study?
Pharmacotherapy has been the mainstay of AF treatment, but AF progression involves irreversible electrical and structural remodelling that reduces the efficacy of rhythm-control therapies, and earlier trials failed to show the superiority of rhythm control on cardiovascular outcomes.
May support early rhythm control before irreversible remodelling; leaves open need for RCTs on cardiovascular outcomes.
Pharmacotherapy has been the mainstay of atrial fibrillation (AF) treatment. As AF progresses from paroxysmal to persistent, electrical and structural remodelling of the atria may become irreversible, rendering future rhythm-control therapies less effective. Results of earlier trials on rhythm control were disappointing and failed to establish the superiority of a rhythm-control strategy on cardiovascular outcomes,
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Pung et al. (2023) conducted an editorial in Paroxysmal atrial fibrillation. Catheter ablation vs. Antiarrhythmic drugs was evaluated on Freedom from atrial fibrillation or atrial tachyarrhythmia. First-line catheter ablation is superior to antiarrhythmic drugs in achieving freedom from atrial fibrillation or atrial tachyarrhythmia in patients with paroxysmal atrial fibrillation.
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