Ablation More Effective for Early Treatment of Atrial Fibrillation

Cryoballoon ablation is more effective as the initial treatment for atrial fibrillation compared to the current standard-of-care management using medications, as per the study by Cleveland Clinic researchers, published in the New England Journal of Medicine.

The Centers for Disease Control and Prevention estimates that atrial fibrillation affects between 2.7 million and 6.1 million people in the United States. About 40 percent of patients experience intermittent episodes of atrial fibrillation, called paroxysmal atrial fibrillation.

‘Initial treatment with ablation may keep patients free from atrial fibrillation longer and prevent the disease progression.’

Atrial fibrillation increase the risk of stroke and heart failure.

Improvements in the safety and efficacy of ablation have led to increased interest in ablation as the initial therapy before using drugs.

Cryoballoon ablation in the process in which the physician inserts a balloon filled with liquid nitrogen to freeze the heart tissue that is causing the irregular heartbeat.

The STOP AF FIRST trial is done on 203 patients with paroxysmal atrial fibrillation over an year at 24 sites across the U.S. The patients were randomized to receive cryoballoon catheter ablation or standard-of-care medications.

At 12 months, 75 percent of the ablation patients were free from atrial fibrillation without additional treatment compared with 45 percent of the medication patients.

"Previous studies have shown success in using ablation early in atrial fibrillation patients, but this is the first to study ablation as the initial therapy early in the AF disease process and the results may signal a shift in how we think about treatment," said Oussama Wazni, M.D., section head of electrophysiology and pacing at Cleveland Clinic and principal investigator of the study.

"Earlier intervention with ablation may keep patients free from atrial fibrillation longer and prevent the disease from progressing into more persistent atrial fibrillation."

Ablation was very safe with only two primary safety events (1.9 percent) observed.



Source: Medindia