Catheter ablation in patients with atrial fibrillation: what will change in daily practice?
Van der Voort, P.H.
Nederlands Tijdschrift Voor Geneeskunde 157(14): A6007
2013
ISSN/ISBN: 1876-8784 PMID: 23548191 Document Number: 666067
A recent publication compared catheter ablation and antiarrhythmic drugs as initial therapy for paroxysmal atrial fibrillation. No difference was seen in the primary endpoint of the cumulative AF burden over two years. The burden of AF was documented objectively by a series of 7-day continuous ECG recordings; a method that will evolve as a gold standard for measuring the AF burden. The major shortcoming of the study was an obsolete ablation endpoint, lacking verification of pulmonary vein isolation. Other drawbacks were the fact that ablations were not exclusively carried out in high-volume centres and a high cross-over rate in the drug group. Also, although the primary endpoint was not significantly different, several secondary outcomes obviously favoured ablation. Outcomes in both the ablation and drug groups were relatively good, and this study will not change the current practice for the majority of paroxysmal AF patients, although catheter ablation could be performed as the initial therapy.