A study published recently in the Journal of the American College of Cardiology will change a way of thinking about the disease atrial fibrillation. And it’s about time. One word describes AF therapy in the past decade: plateau. Ten years have passed and we have no new drugs and no real breakthrough in AF ablation.
ARREST-AF was an ablation study that showed success rates after the procedure can be increased five-fold. That’s not a typo. But it’s also not the most important lesson from the trial.
ARREST-AF will be influential, paradigm-changing even, because it further confirms that AF, in most cases, is a diffuse disease of the atria. Successful treatment, therefore, requires more than just a focal solution, such as pulmonary vein isolation. It requires other things.
An analogy comes in interventional cardiology. Here, my colleagues place stents (metal cages) into discrete areas of narrowing. That process improves the physics of flow at that point but does nothing for the systemic disease of atherosclerosis. This is why stents don’t prevent heart attacks or death in chronic arterial disease: because a focal solution doesn’t address the widespread disease.
So what did the AF researchers do? What were their findings? How will it change the paradigm of treating AF?
I wrote about ARREST-AF over at theHeart.org|Medscape Cardiology.
Here is the title and the link: ARREST-AF: A Turning Point in AF Care
Reference: ARREST AF: http://www.sciencedirect.com/science/article/pii/S0735109714064675
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