Feature | May 14, 2012

Catheter Ablation Superior to Drug Therapy as First-Line Treatment for AFib

Preliminary RAAFT study findings presented at HRS 2012 scientific meeting

May 14, 2012 — Patients with the heart rhythm disorder atrial fibrillation (AFib) who received first-line catheter ablation treatment had a longer arrhythmia-free interval than patients receiving anti-arrhythmic drugs, the standard first-line treatment. The preliminary findings were presented during a late-breaking session at the Heart Rhythm Society (HRS) 2012 scientific sessions last week in Boston.

The study found that, compared to treatment with anti-arrhythmic drugs, radiofrequency catheter ablation significantly extended the time to first recurrence of AFib, atrial tachyarrhythmia, atrial flutter and asymptomatic AFib, in patients with paroxysmal recurrent AFib who had not been previously treated with an anti-arrhythmic drug. Paroxysmal atrial fibrillation is defined as recurrent (two or more) episodes of AFib that end spontaneously in less than seven days.

“This study supports consideration of catheter ablation as a first-line treatment option for patients with paroxysmal AFib,” said Carlos Morillo, M.D., FHRS, Hamilton Health Sciences-McMaster University, Hamilton, Canada, and co-principal investigator for the study. “This research is promising, as the results demonstrated better safety and effectiveness outcomes in AFib patients, not previously treated with drugs, who underwent radiofrequency ablation.”

Atrial fibrillation is the most common arrhythmia, or heart rhythm disorder. Other similar conditions include atrial tachyarrhythmia and atrial flutter. AFib is caused by disorganized electrical activity in the heart. Leading medical societies including the American Heart Association, American College of Cardiology and the European Society of Cardiology recommend catheter ablation as second-line therapy for AFib. The most common first-line treatment is anti-arrhythmia drugs; however, in certain patients they are not effective. Recent data indicate that more than 35 percent of patients will have recurrence of AFib despite best anti-arrhythmic drug therapy, and more than 30 percent of patients will discontinue the drugs because of adverse reactions.

Study Findings

The study, called First Line Radiofrequency Ablation versus Anti-arrhythmic Drugs for Atrial Fibrillation Treatment: A Multicenter Randomized Trial (RAAFT), was a multicenter, unblinded, parallel-arm clinical trial involving 127 patients with paroxysmal recurrent AFib. The study’s primary objective was to determine whether catheter ablation is superior to anti-arrhythmic drugs as a first-line therapy. A secondary endpoint was time to first occurrence of any event in a cluster of serious complications that occur in patients.

The study enrolled patients with a history of paroxysmal AFib. Participants were randomized into two groups, with 66 receiving pulmonary vein isolation using radiofrequency (RF) catheter ablation, and 61 receiving anti-arrhythmic drug therapy. Patients in the drug therapy arm were prescribed Dronedarone, Flecainide, Propafenone, Sotalol or Amiodarone.

The study patients were followed for two years. Catheter ablation was performed on day zero or the anti-arrhythmic drug therapy was optimized during the first 90 days. In a follow-up period from 90 days to 24 months, recurrence of symptomatic or asymptomatic paroxysmal atrial fibrillation, atrial flutter or atrial tachycardia was detected via intensive heart rhythm monitoring.

“This study demonstrated radiofrequency AFib ablation to be safe and superior to drug therapy in extending time to first recurrence of symptomatic or asymptomatic AFib, atrial tachyarrhythmia and atrial flutter, with a relative risk reduction of 44 percent [Hazard ratio = 0.56 (0.35 – 0.90), p= 0.016],” said Andrea Natale, M.D., FACC, FHRS, St. David’s Medical Center, Austin, Texas and co-principal investigator for the study. “In addition, the incidence of protocol-specified, treatment-related adverse safety events was 20 percent for the drug arm subjects vs. 8 percent for the RF ablation arm subjects.”

The study was sponsored by the Population Health Research Institute, McMaster University and Hamilton Health Sciences and funded by a research grant from Biosense Webster. Natale is compensated for his services as a member of the company’s scientific advisory board and provides other consulting services.

For more information: www.HRSonline.org

Related Content

ICDs, non-ischemic cardiomyopathy, University of Alabama at Birmingham study, Circulation
News | Implantable Cardioverter Defibrillators (ICD)| January 18, 2017
A new study published in Circulation has found there is a 23 percent risk in reduction of all-cause mortality in non-...
LindaCare, expansion, remote patient monitoring, CIEDs, cardiac implantable electronic devices, United States
News | Remote Monitoring| January 18, 2017
LindaCare announced that it will open a new customer support facility in Connecticut to support growing interest in...
ICDs, implantable cardioverter defibrillators, survival rate, elderly patients, JACC study
News | Implantable Cardioverter Defibrillators (ICD)| January 17, 2017
Of patients over age 65 who received an implantable cardioverter-defibrillator (ICD) after surviving sudden cardiac...
St. Jude Medical, Amplatzer Amulet LAA Occluder, observational study, TCT 2016
News | Left Atrial Appendage (LAA) Occluders| November 03, 2016
St. Jude Medical Inc. presented favorable results from the largest observational study to date of the company’s...
RFID inventory control in the cath lab, inventory management, cardinal

An example of RFID cabinets in a cath lab. As items are pulled from the cabinet, the inventory control system automatically determines what items were take out and adds them to the patient case. The system can also help locate recalled or expired items, and automatically track on-hand inventory to avoid manual counts.

Feature | Inventory Management| October 28, 2016 | Jean-Claude Saghbini
The healthcare industry’s transition to value-based care leaves no room for waste, and yet we know that inefficiency
Sponsored Content | Videos | Sudden Cardiac Arrest| October 28, 2016
It is critical to educate patients who are at risk of sudden cardiac arrest (SCA), so Rahul Doshi, M.D., director of
Sponsored Content | Videos | Inventory Management| October 28, 2016
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from hi
Acutus Medical, AcQMap High Resolution Imaging and Mapping System, atrial fibrillation, UNCOVER-AF trial, first procedure
News | EP Mapping and Imaging Systems| October 27, 2016
Acutus Medical announced the completion of the first patient procedure in the “Utilizing Novel Dipole Density...
BioTrace Medical Tempo temporary pacing lead, TAVR
Technology | Heart Valve Technology| October 27, 2016
October 27, 2016 — BioTrace Medical Inc. said it received U.S.
Niobe remote magnetic navigation system, cardiac abltion, Robert Wood Johnson University Hospital, New Jersey, 500 procedures
News | Robotic Systems| October 25, 2016
Stereotaxis Inc. and Robert Wood Johnson University Hospital (RWJUH) announced that Zyad Younan, M.D., has completed...
Overlay Init