Trial Offers Little Support for Early Use of Radiofrequency Ablation in Atrial Fibrillation — Physician’s First Watch
Trial Offers Little Support for Early Use of Radiofrequency Ablation in Atrial Fibrillation
By Larry Husten
A new, industry-supported trial offers little support for early use of radiofrequency ablation to treat atrial fibrillation. The findings appear in JAMA.
Some 130 patients with paroxysmal AF were randomized to antiarrhythmic therapy or radiofrequency ablation as initial treatment. After 2 years, a documented atrial arrhythmia had occurred more often in the drug group than in the ablation group (72% vs. 55%). However, the difference in symptomatic arrhythmias alone, while statistically significant, was much smaller (59% vs. 47%). Four cases of cardiac tamponade occurred with ablation.
The authors note that the high rate of cardiac tamponade indicates that ablation "carries considerable risks that need to be discussed with the patient" when offering it as first-line therapy.
A JAMA editorialist (and contributing editor for NEJM Journal Watch) says the overall findings serve as "a powerful endorsement" of the current guidelines, which recommend radiofrequency ablation only after drug therapy has failed.
Adapted from CardioExchange