Anti-arrhythmics vs ablation for paroxysmal Afib

In this large randomized trial of patients with symptomatic paroxysmal Afib, they were randomized to treatment with radiofrequency ablation, or Class IC / III anti-arrhythmics. There was no difference in rates of freedom from Afib between the groups at up to 18 months follow up, but the rates at 24 months were lower in the ablation group (93% vs 84%). However, in the ablation group, there was 1 procedure-related death, and 3 cases of tamponade. Given the risks, anti-arryhthmics should be tried before ablation in patients with symptomatic paroxysmal Afib. (abstract)

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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