Dr John M

cardiac electrophysiologist, cyclist, learner

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Atrial fibrillation ablation in the news. Some good science…

January 28, 2010 By Dr John

Catheter Ablation of the planets most ubiquitous arrhythmia, atrial fibrillation was in the news this week.  A study showing pulmonary vein isolation is far more effective than drugs for controlling AF in a relatively young healthy patient cohort who has failed a prior anti-arrhythmic drug.

It strikes me as an intellectually honest study:

5645 patients screened with all but 167 excluded.
Solid endpoints and adequate monitoring post ablation.
Clear superiority of ablation in this specific cohort.

As an active ablator of AF this is a confirmatory study.  I read with extreme satisfaction the comment…
“Patients with significant left ventricular dysfunction, more persistent forms of AF, and advanced degrees of heart failure were excluded. The results of our study cannot be extrapolated to these latter populations.”

Hopefully, this line will prevent the misguided notion that ablation is best therapy for all AF.  For the 167 patients culled from a huge group of over 5000, ablation was clearly superior than drugs but, as rightly pointed out by the authors this was a select group indeed.

A solid confirmation for which is practiced presently.   Comforting.  Good science, but much work remains as these 167/5645 represents much less than 3% of all AF patients.

JMM

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Related posts:

  1. Happiness is the disappearance of squiggles…
  2. Day 3 Atrial Fibrillation Symposium: Homeward bound and a discovery…
  3. Day 2: Atrial Fibrillation Symposium. Good doctoring…
  4. A cyclist at the Atrial Fibrillation Symposium- Day 1. Athletes and AFib get some press…

Filed Under: AF ablation, Atrial fibrillation, General Ablation Tagged With: Pulmonary Vein Isolation

John Mandrola, MD

Welcome, Enjoy, Interact. john-mandrola I am a cardiac electrophysiologist practicing in Louisville KY. I am also a husband to a palliative care doctor, a father, a bike racer, and a regular columnist at theHeart.org | Medscape

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For patients...Educational posts

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  • AF ablation — 2015 A Cautionary Note
  • AF Ablation in 2012–An easier journey?
  • Atrial Flutter — 15 facts you may want to know.
  • Benign PVCs: A heart rhythm doctor’s approach.
  • Caution with early Cardioversion
  • Decisions of 2 low-risk cases of PAF
  • Defining success in AF ablation in 2014
  • Four commonly asked questions on AF ablation
  • Inflammation and AF — Get off the gas
  • Ten things to expect after AF ablation
  • The medical decsion as a gamble
  • The most important verb in our health crisis
  • Wellness Requires Ownership

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