Catheter Ablation as First-Line Therapy for Atrial Fibrillation: Ready for Prime-Time?
Current guidelines include atrial fibrillation (AF) catheter ablation as part of the management strategy in patients that have failed at least one oral antiarrhythmic drug treatment course. However, growing evidence derived from both randomized and non-randomized studies demonstrate lower rates of AF recurrence and AF burden in patients with paroxysmal AF that are naïve to antiarrhythmic drug treatment. Furthermore, progression from paroxysmal AF to persistent AF appears to be delayed by early catheter ablation of AF. The current review addresses the question of the best timing for ablation in patients with paroxysmal AF and provides the rationale for offering AF ablation as first-line therapy based on the most updated evidence available.
Arrhythmia & Pacing Service, Hamilton Health Science, McMaster University, 237 Barton St East. David Braley CVSRI, Room 3C-120, Hamilton, ON, Canada, L8L 2X2.
Aldo G
AG
Carrizo
Department of Medicine, Arrhythmia & Pacing Service, Hamilton Health Science, McMaster University, Hamilton, ON, Canada, L8L 2X2. morillo@hhsc.ca.|Population Health Research Institute, David Braley CVSRI, Room 3C-120, Hamilton, ON, Canada, L8L 2X2. morillo@hhsc.ca.
Carlos A
CA
Morillo
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000628:therapy*; D064752:Atrial Remodeling; D017115:Catheter Ablation / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D015201:Meta-Analysis as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents
Atrial fibrillation; Atrial remodeling; Catheter ablation; Paroxysmal