Might Catheter Ablation of Atrial Fibrillation Provide a Better Outcome Than Antiarrhythmic Therapy?
The criticism of antiarrhythmic drug therapy as the preferred therapy for atrial fibrillation is based on the side effects of these drugs. Therefore, if it were possible to maintain sinus rhythm without the use of antiarrhythmic drugs, might a primary approach stressing restoration of sinus rhythm become more attractive? Catheter ablation of atrial fibrillation, more precisely termed catheter-based isolation of the pulmonary veins, is an increasingly used procedure for patients with symptomatic arrhythmia. It has been suggested that this technique is highly successful when performed by experienced operators, although the long-term efficacy is not perfect, and severe side effects can occur in a small minority of patients. In a nonrandomized study, Pappone et al67 compared outcomes among 589 patients who had undergone radiofrequency ablation for atrial fibrillation with outcomes among 582 patients who had received drug therapy. The authors suggested that restoration of sinus rhythm by pu
