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Study Supports Catheter Ablation for Atrial Fibrillation

Ablation linked to better outcomes than meds in a-fib patients unresponsive to previous drug

TUESDAY, Jan. 26 (HealthDay News) -- In individuals with atrial fibrillation and a history of non-response to antiarrhythmic drugs, radiofrequency catheter ablation is associated with improved outcomes compared to alternate drug therapy, according to research published in the Jan. 27 issue of the Journal of the American Medical Association.

David J. Wilber, M.D., of the Loyola University Medical Center in Maywood, Ill., and colleagues analyzed data from 167 subjects with recent symptomatic atrial fibrillation episodes and a lack of response to at least one antiarrhythmic drug. Patients were randomized to receive ablation or a previously unused antiarrhythmic drug. The primary end point was freedom from treatment failure, including symptomatic paroxysmal atrial fibrillation.

After nine months, the researchers found that 66 percent in the ablation group remained free of treatment failure, compared to 16 percent of the medication group (hazard ratio, 0.30). Beginning at three months, quality-of-life scores improved significantly in the catheter group compared to the drug group, and persisted throughout the study.

"Our multicenter randomized trial demonstrates the superiority of catheter ablation over antiarrhythmic drug therapy in the treatment of patients with paroxysmal atrial fibrillation who did not respond to one or more drugs," the authors write. "These findings argue for early use of catheter ablation therapy in patients with paroxysmal atrial fibrillation unresponsive to initial attempts with pharmacologic control."

The study was funded by Biosense Webster, which provided the catheters in the study. The authors reported financial relationships with a variety of medical device and pharmaceutical companies, including Biosense Webster.

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