Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation - A randomized trial

  • Wazni O
  • Marrouche N
  • Martin D
 et al. 
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Context Treatment with antiarrhythmic drugs and anticoagulation is considered first-line therapy in patients with symptomatic atrial fibrillation (AF). Pulmonary vein isolation (PVI) with radiofrequency ablation may cure AF, obviating the need for antiarrhythmic drugs and anticoagulation. Objective To determine whether PVI is feasible as first-line therapy for treating patients with symptomatic AF. Design, Setting, and Participants A multicenter prospective randomized study conducted from December 31, 2001, to July 1, 2002, of 70 patients aged 18 to 75 years who experienced monthly symptomatic AF episodes for at least 3 months and had not been treated with antiarrhythmic drugs. Intervention Patients were randomized to receive either PVI using radiofrequency ablation (n=33) or antiarrhythmic drug treatment (n=37), with a 1-year follow-up. Main Outcome Measures Recurrence of AF, hospitalization, and quality of life assessment. Results Two patients in the antiarrhythmic drug treatment group and 1 patient in the PVI group were lost to follow-up. At the end of 1-year follow-up, 22 (63%) of 35 patients who received antiarrhythmic drugs had at least 1 recurrence of symptomatic AF compared with 4 (13%) of 32 patients who received PVl (P

Author-supplied keywords

  • affirm
  • catheter ablation
  • complication
  • esophageal fistula
  • flutter
  • maintenance
  • management
  • pulmonary vein isolation
  • sinus rhythm
  • stenosis

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  • O M Wazni

  • N F Marrouche

  • D O Martin

  • A Verma

  • M Bhargava

  • W Saliba

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