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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