Cardiac Ablation Superior for Afib Therapy

Radiofrequency ablation shown superior for atrial fibrillation over arrhythmia drugs

(RxWiki News) A new study suggests that patients with a common heart arrhythmia could be best treated with cardiac ablation -- a procedure that destroys heart tissue responsible for the heart rhythm disorder -- over drugs.

Medication is usually the first line treatment for atrial fibrillation patients, though researchers suggest the finding that ablation was significantly superior should bump it up as an initial therapy.

"Talk to your cardiologist about arrhythmia treatment options."

Carlos Morillo, MD, FHRS, author of the study and professor in the division of cardiology with the department of medicine at McMaster University in Canada, said he believes the findings are significant enough to suggest a change in how patients are treated when they seek atrial fibrillation treatment for the first time.

He said the finding proved the more invasive procedure is safer, more effective and results in fewer complications.

During the randomized Radiofrequency Ablation vs. Antiarrhythmic Drugs as First-Line Treatment of Symptomatic Atrial Fibrillation (RAAFT 2) clinical trial researchers enrolled 127 atrial fibrillation patients at 16 centers in five countries. Most were men and the average participant age was 55.

Of those participants 66 received pulmonary vein isolation (PVI) with radiofrequency ablation while the remainder took anti-arrhythmic drugs.

Effectiveness of the two treatments was measured by the amount of time it took to document an occurrence of atrial fibrillation through electrocardiography (ECG).

This means that higher percentages of patients experiencing a recurrent arrhythmia suggests a less favorable outcome.

Among patients taking medication, 72 percent recorded a recurrent episode compared to 55 percent of the group that received cardiac ablation. In addition, 20 percent of patients taking medication suffered serious complications compared to 8 percent who received ablation. There were no patient deaths reported in either group.

“The analysis revealed that a higher rate of adverse events occur in patients that begin anti-arrhythmic drugs first, which is currently the recommended first-line treatment practice," said Dr. Morillo.

"Our trial showed that ablation is superior in the real world, and is a more effective and safer course of first-line treatment with less patient complications.”

The study was funded by Johnson & Johnson, which sells catheters used to treat atrial fibrillation. The findings were presented Friday at the Heart Rhythm Society meeting in Boston, Mass.

Review Date: 
May 11, 2012