Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation.

The New England Journal of Medicine
Jason G AndradeEARLY-AF Investigators

Abstract

Guidelines recommend a trial of one or more antiarrhythmic drugs before catheter ablation is considered in patients with atrial fibrillation. However, first-line ablation may be more effective in maintaining sinus rhythm. We randomly assigned 303 patients with symptomatic, paroxysmal, untreated atrial fibrillation to undergo catheter ablation with a cryothermy balloon or to receive antiarrhythmic drug therapy for initial rhythm control. All the patients received an implantable cardiac monitoring device to detect atrial tachyarrhythmia. The follow-up period was 12 months. The primary end point was the first documented recurrence of any atrial tachyarrhythmia (atrial fibrillation, atrial flutter, or atrial tachycardia) between 91 and 365 days after catheter ablation or the initiation of an antiarrhythmic drug. The secondary end points included freedom from symptomatic arrhythmia, the atrial fibrillation burden, and quality of life. At 1 year, a recurrence of atrial tachyarrhythmia had occurred in 66 of 154 patients (42.9%) assigned to undergo ablation and in 101 of 149 patients (67.8%) assigned to receive antiarrhythmic drugs (hazard ratio, 0.48; 95% confidence interval [CI], 0.35 to 0.66; P<0.001). Symptomatic atrial tachyarrhyt...Continue Reading

Associated Clinical Trials

References

Sep 16, 1998·The American Journal of Cardiology·D M Roden
Jun 2, 2005·JAMA : the Journal of the American Medical Association·Oussama M WazniAndrea Natale
Dec 13, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Paul D ZieglerRahul Mehra
Jan 28, 2010·JAMA : the Journal of the American Medical Association·David J WilberUNKNOWN ThermoCool AF Trial Investigators
Oct 26, 2012·The New England Journal of Medicine·Jens Cosedis NielsenPeter Steen Hansen
Mar 19, 2013·Journal of the American College of Cardiology·Douglas L PackerUNKNOWN STOP AF Cryoablation Investigators
Oct 10, 2013·Journal of Cardiovascular Electrophysiology·Jason G AndradePaul Khairy
Feb 19, 2014·European Heart Journal·Stanley NattelA John Camm
Feb 20, 2014·JAMA : the Journal of the American Medical Association·Carlos A MorilloUNKNOWN RAAFT-2 Investigators
Mar 11, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Prashanthan SandersUNKNOWN Reveal LINQ Usability Investigators
Feb 25, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Gareth J PadfieldCharles R Kerr
May 17, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hugh CalkinsTeiichi Yamane
Oct 21, 2018·American Heart Journal·Jason G AndradeUNKNOWN EARLY-AF Study Investigators
Aug 21, 2020·JACC. Clinical Electrophysiology·Jason G AndradeUNKNOWN CIRCA-DOSE Study Investigators
Sep 1, 2020·The New England Journal of Medicine·Paulus KirchhofUNKNOWN EAST-AFNET 4 Trial Investigators
Nov 17, 2020·The Canadian Journal of Cardiology·Jason G AndradeUNKNOWN Members of the Secondary Panel

❮ Previous
Next ❯

Citations

Nov 26, 2020·Nature Reviews. Cardiology·Irene Fernández-Ruiz
Dec 22, 2020·Journal of Cardiovascular Electrophysiology·Graham Lohrmann, Rod Passman
Jan 28, 2021·The New England Journal of Medicine·Gregory F Michaud, William G Stevenson
Jan 28, 2021·The New England Journal of Medicine·Joseph E Marine
Jan 12, 2021·Journal of Cardiovascular Electrophysiology·Jonathan Chrispin, Joseph E Marine
Feb 4, 2021·Journal of Cardiovascular Electrophysiology·Lohit Garg, Pasquale Santangeli
Mar 31, 2021·Herzschrittmachertherapie & Elektrophysiologie·Ruben SchlebergerBruno Reissmann
Mar 25, 2021·Journal of Cardiovascular Electrophysiology·Nazem Akoum
Apr 11, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Bart A MulderYuri Blaauw
Apr 13, 2021·Advances in Therapy·Aileen KearneyIan B A Menown
Apr 27, 2021·Circulation·Anne M Gillis, Stephen B Wilton
Apr 21, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Márcio Jansen de Oliveira FigueiredoManlio F Márquez
Apr 22, 2021·European Heart Journal·Leonarda Galiuto, Massimo Volpe
May 1, 2021·Journal of Cardiovascular Electrophysiology·Andreas MetznerChristoph Sinning
May 28, 2021·The New England Journal of Medicine·Joseph E Marine
May 28, 2021·Journal of Cardiovascular Electrophysiology·Martha M O McGilvrayRalph J Damiano
Jun 30, 2021·Der Internist·Renate B SchnabelPaulus Kirchhof
Jun 22, 2021·Pacing and Clinical Electrophysiology : PACE·Lorenzo BianchiniK R Julian Chun
Jul 11, 2021·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Pedro Adragão
Jul 30, 2021·World Journal of Methodology·Valeria FaddaAndrea Messori
Jul 25, 2021·Journal of Clinical Medicine·Diego PenelaRiccardo Cappato
Jul 24, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michal Miroslaw FarkowskiSerge Boveda
Jul 29, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Sven KnechtMichael Kühne
Jul 30, 2021·Journal of the American Heart Association·Arvindh Kanagasundram, William G Stevenson
Aug 4, 2021·Deutsche medizinische Wochenschrift·Benjamin SchäfferStephan Willems
Aug 11, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Rainer HoffmannJochen Michaelsen
Aug 19, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Shaojie ChenJulian K R Chun
Aug 21, 2021·JACC. Clinical Electrophysiology·Daniel StevenArian Sultan
Aug 28, 2021·Scientific Reports·Ángel Ferrero-De-Loma-OsorioUNKNOWN RECABA Investigators
Aug 19, 2021·Pacing and Clinical Electrophysiology : PACE·Bert VandenberkPeter Haemers
Aug 28, 2021·Journal of the American College of Cardiology·Jason G AndradeRicky D Turgeon
Aug 29, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Josip KatićZrinka Jurišić

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.