Should I have my atrial fibrillation ablation now or should I wait for better technology to arrive?
The new England Journal of Medicine recently published an important study (EAST-AFNET August 2020) asking whether or not an early rhythm control strategy would reduce cardiovascular outcomes for patients who had a clear diagnosis of atrial fibrillation (AF) compared to usual care.
The results were clear enough that the trial was stopped early in favor of the patients who were randomized to the rhythm control arm which included an early Ablation strategy for AF management.
In 135 countries,2789 patients were enrolled in the trial in the primary outcomes were cardiovascular events including death, stroke, and hospitalization for worsening heart failure or acute coronary syndrome. Patients who were assigned early rhythm control were 1.3x more likely to avoid a cardiovascular outcome.
The rhythm control included a strategy of early Ablation including a pulmonary vein isolation procedure, as well as early use of antiarrhythmic drugs to try and maintain normal sinus rhythm from the outset.￼
Is new technology on the horizon?
With respect to atrial fibrillation Ablation, there is always going to be new technology on the horizon and this has been the case over the last 15 years. However, the procedural efficiencies and safety at the present moment suggest that any new are technologies will only provide a very small incremental Improvement in the success rates and a small reduction in complication rates in what is a ready very established procedure.
Cryoablation using a balloon technology that aims to freeze the pulmonary veins to cause pulmonary vein isolation is already a very effective technology providing a 75–80% success rate for paroxysmal atrial fibrillation whilst having a complication rate of less than 2% with a serious complication rate of less than 0.5%. All this is typically under an hour and a procedure that allows the same-day discharge.
Do you understand more about the benefits of cryoablation compared to radiofrequency ablation for the treatment of atrial fibrillation, please see this article .
To understand how and atrial fibrillation ablation procedure is performed through a catheter ablation technique (keyhole surgery), please click on the video link below.
If you have Atrial fibrillation, particularly if you wish to consider an early treatment option with either the best drugs currently, or consider an ablation strategy to resolve the symptoms of Atrial fibrillation, then please get in touch with Dr. Boon Lim, a top-rated London specialist in atrial fibrillation to discuss the most up-to-date treatment options for AF.