Cryoablation or drug therapy for initial treatment of atrial fibrillation
Fri, 11/20/2020 – 10:30
The EARLY-AF study investigated how catheter ablation compares with antiarrhythmic drugs as a first-line therapy for patients with atrial fibrillation (AF). With the goal of achieving sinus rhythm control, researchers randomized 154 treatment-naive patients to catheter ablation with a cryothermy balloon and 149 others to antiarrhythmic medication. All participants were implanted with a cardiac monitoring device to detect atrial tachyarrhythmia. The primary outcome was first recurrence of AF, atrial flutter, or atrial tachycardia 91–365 days after treatment initiation. At 1-year followup, the endpoint was documented in 42.9% of enrollees in the ablation group and 67.8% of those in antiarrhythmic drug group. Symptomatic atrial tachyarrhythmia recurred in 11% of patients who underwent ablation and 26.2% of patients who took antiarrhythmic drugs. Median time spent in AF was 0% and 0.13%, respectively, and the rate of serious adverse events was 3.2% and 4.0% of patients, respectively. The results demonstrate a significantly lower rate of AF recurrence with catheter cryoballoon ablation than with antiarrhythmic drug therapy, based on continuous cardiac rhythm monitoring.