Ablation Therapy for Atrial Tachycardias: Some Answers, More Questions

A meta-analysis of four randomized comparison trials suggests that ablation may have the edge over drug treatment — but also highlights the paucity of evidence.

Radiofrequency catheter ablation for rhythm control has become a common treatment for atrial fibrillation. According to current guidelines, ablation is appropriate as second-line therapy for patients who fail antiarrhythmic drugs (Journal Watch Cardiology Sep 13 2006), and some advocate it as first-line therapy. However, no large randomized trial of this invasive and expensive procedure has been completed to support such an approach.

Investigators identified four randomized controlled trials in which circumferential pulmonary vein ablation was compared with antiarrhythmic drug therapy in patients with atrial tachyarrhythmias, and in which Holter monitoring with or without electrocardiography was used to document recurrences within 1 year aft…

Reviewing Author

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)