Catheter ablation as an early rhythm control strategy reduces arrhythmia recurrence and adverse cardiovascular outcomes in patients with atrial fibrillation.
Does early catheter ablation improve clinical outcomes and reduce arrhythmia recurrence in patients with atrial fibrillation?
This review highlights the growing evidence supporting early catheter ablation as a first-line rhythm control strategy to prevent disease progression and improve clinical outcomes in atrial fibrillation.
Catheter Ablation (CA) is an effective therapeutic option in treating atrial fibrillation (AF). Importantly, recent data show that CA as a rhythm control strategy not only significantly reduces AF burden, but also substantially improves clinical hard endpoints. Since AF is a progressive disease, the time of Diagnosis-to-Intervention appears crucial. Recent evidence shows that earlier rhythm control is associated with a lower risk of adverse cardiovascular outcomes in patients with early AF. Particularly, CA as an initial first line rhythm control strategy is associated with significant reduction of arrhythmia recurrence and rehospitalization in patients with paroxysmal AF. CA is shown to significantly lower the risk of progression from paroxysmal AF to persistent AF. When treating persistent AF, the overall clinical success after ablation remains unsatisfactory, however the ablation outcome in patients with "early" persistent AF appears better than those with "late" persistent AF. "Adjunctive" ablation on top of pulmonary vein isolation (PVI), e.g., ablation of atrial low voltage area, left atrial posterior wall, vein of Marshall, left atrial appendage, etc., may further reduce arrhythmia recurrence in selected patient group. New ablation concepts or new ablation technologies have been developing to optimize therapeutic effects or safety profile and may ultimately improve the clinical outcome.
Chen et al. (Mon,) conducted a review in Atrial Fibrillation. Catheter Ablation was evaluated. Catheter ablation as an early rhythm control strategy reduces arrhythmia recurrence and adverse cardiovascular outcomes in patients with atrial fibrillation.