A systematic review of randomized trials comparing radiofrequency ablation with antiarrhythmic medications in patients with atrial fibrillation.
BACKGROUND
Atrial fibrillation (AF) is the most frequent arrhythmia seen in clinical practice. Until recently, antiarrhythmic medications have been the only commonly employed treatment for maintaining sinus rhythm. However, antiarrhythmic medications have a modest long-term efficacy and the potential for serious side effects. Radiofrequency (RF) ablation is now emerging as a viable alternative to antiarrhythmic medications in maintaining sinus rhythm in patients with AF. Several randomized trials comparing RF ablation with antiarrhythmic medications have now been published.


OBJECTIVE
To perform a systematic review of published randomized trials comparing RF ablation with antiarrhythmic medications in the treatment of AF.


METHODS
A systematic review of the literature was performed and two authors independently abstracted the data from trials. A statistical analysis was performed using Comprehensive Meta-Analysis Software (BIOSTAT, Englewood, NJ, USA).


RESULTS
A total of six trials were identified. Overall, RF ablation reduced the risk of AF recurrence by 65% at 1 year compared with antiarrhythmic medications.


CONCLUSIONS
In selected patients with AF, RF ablation reduced the risk of AF recurrence at 1 year by 65% compared with antiarrhythmic medications.
Nair
Girish M
GM
Division of Cardiology, Arrhythmia Service, McMaster University and Hamilton Health Sciences, Ontario, Canada. nairg@mcmaster.ca
Nery
Pablo B
PB
Diwakaramenon
Syamkumar
S
Healey
Jeffrey S
JS
Connolly
Stuart J
SJ
Morillo
Carlos A
CA
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D004562:Electrocardiography; D006801:Humans; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents