A-Fib Burden Similar With Ablation, Antiarrhythmic Meds

No difference in cumulative burden over two years with ablation, antiarrhythmics as initial therapy

WEDNESDAY, Oct. 24 (HealthDay News) -- For patients with paroxysmal atrial fibrillation with no history of antiarrhythmic drug use, there is no significant difference in the cumulative burden of atrial fibrillation over two years between the treatment strategies of radiofrequency catheter ablation or antiarrhythmic agents, according to a study published in the Oct. 25 issue of the New England Journal of Medicine.

Jens Cosedis Nielsen, M.D., D.M.Sc., from the Aarhus University Hospital in Denmark, and colleagues randomly allocated 294 patients with paroxysmal atrial fibrillation with no history of antiarrhythmic drug use to initial treatment with either radiofrequency catheter ablation (146 patients) or drug therapy with class IC or III antiarrhythmic agents (148 patients). Seven-day Holter-monitor recordings were carried out at three, six, 12, 18, and 24 months of follow-up.

The researchers found that the cumulative burden of atrial fibrillation was not significantly different between the ablation and drug therapy groups, nor was there a significant difference in the burden at three, six, 12, or 18 months. The burden of atrial fibrillation was significantly lower in the ablation group at 24 months (90th percentile, 9 versus 18 percent), and significantly more patients in the ablation group were free from any atrial fibrillation (85 versus 71 percent) and symptomatic atrial fibrillation (93 versus 84 percent). Thirty-six percent of patients in the drug therapy group underwent supplementary ablation.

"In conclusion, our study of radiofrequency ablation as compared with antiarrhythmic drug therapy as an initial strategy in patients with paroxysmal atrial fibrillation showed no significant difference between the two treatment strategies in the cumulative burden of atrial fibrillation over a period of two years," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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