Key result
Catheter ablation appears more effective than AADs for long-term sinus rhythm but lacks first-line evidence.
Why the study?
Does catheter ablation improve long-term maintenance of sinus rhythm compared to antiarrhythmic drug therapy in patients with symptomatic atrial fibrillation?
Does catheter ablation improve long-term maintenance of sinus rhythm compared to antiarrhythmic drug therapy in patients with symptomatic atrial fibrillation?
While catheter ablation is more effective than antiarrhythmic drugs for maintaining sinus rhythm in selected patients with atrial fibrillation, it is not recommended as first-line therapy for the majority of patients.
Supports considering ablation for rhythm control in selected AF; leaves open first-line use pending higher-level evidence.
Antiarrhythmic drug (AAD) therapy may be beneficial for patients with symptoms attributable to atrial fibrillation despite adequate rate control. The limited long‐term efficacy of AAD and the relatively large proportion of patients discontinuing therapy because of side effects led to the development of nonpharmacological therapies to achieve rhythm control. Pressing questions remain about the effect of ablation therapy on long‐term patient outcomes. Based on recent clinical trials and meta‐analyses, ablation appears more effective and possibly safer than AAD for long‐term maintenance of sinus rhythm in selected patients, but the evidence is insufficient to recommend ablation in preference to drug therapy as the first AAD therapy for the majority of patients in whom a rhythm control strategy is justified. Herein, we review the most current evidence supporting the use of AAD and catheter ablation in atrial fibrillation.
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Viles-González et al. (2011) conducted a review in Atrial fibrillation. Catheter ablation vs. Antiarrhythmic drugs (AAD) was evaluated. Catheter ablation appears more effective and possibly safer than antiarrhythmic drugs for long-term maintenance of sinus rhythm in selected patients, though evidence is insufficient for first-line use.
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