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Abstract
Evaluation of: Wilber DJ, Pappone C, Neuzil P et al.; ThermoCool AF Trial Investigators. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA 303(4), 333–340 (2010).
Atrial fibrillation is the most common cardiac arrhythmia and is responsible for the highest number of cardioembolic strokes worldwide. Discovery of the role of pulmonary veins as a trigger has been an important breakthrough that has led to the development of catheter ablation, an established curative therapy for drug-resistant atrial fibrillation. In a systematically conducted prospective, multicenter, randomized trial comparing pulmonary vein isolation-based catheter ablation with pharmacological rhythm control, the currently recommended first-line therapy in atrial fibrillation, catheter ablation, proved superior to antiarrhythmic drugs with regards to the maintenance of sinus rhythm and improvement in symptoms and quality of life at 1 year of follow-up, with comparable adverse event rates. Early use of catheter ablation in selected patients with paroxysmal atrial fibrillation unresponsive to one antiarrhythmic drug is promising.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.