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Debate persists about which patients with atrial fibrillation who fail antiarrhythmic drug (AAD) therapy should undergo catheter ablation. In a randomized trial from Italy, radiofrequency pulmonary-vein ablation showed promise for treating drug-refractory paroxysmal AF (JW Cardiol Jan 3 2007). Now, investigators have conducted an international trial to broaden the scope of that research. A catheter manufacturer funded the study.
A total of 167 patients (mean age, 56; 67% men) with paroxysmal AF who had failed AAD therapy with at least one drug were randomized 2:1 to undergo radiofrequency pulmonary-vein ablation or to continue AAD therapy with a previously unused drug, most often flecainide or propafenone. Notably, patients who had used amio…