Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data

Shaojie Chen; Helmut Pürerfellner; Feifan Ouyang; Márcio Galindo Kiuchi; Christian Meyer; Martin Martinek; Piotr Futyma; Lin Zhu; Alexandra Schratter; Jiazhi Wang; Willem-Jan Acou; Zhiyu Ling; Yuehui Yin; Shaowen Liu; Philipp Sommer; Boris Schmidt; Julian K R Chun

doi:10.1093/europace/euab185

Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data

Standard

Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data. / Chen, Shaojie; Pürerfellner, Helmut; Ouyang, Feifan; Kiuchi, Márcio Galindo; Meyer, Christian; Martinek, Martin; Futyma, Piotr; Zhu, Lin; Schratter, Alexandra; Wang, Jiazhi; Acou, Willem-Jan; Ling, Zhiyu; Yin, Yuehui; Liu, Shaowen; Sommer, Philipp; Schmidt, Boris; Chun, Julian K R.

In: EUROPACE, Vol. 23, No. 12, 07.12.2021, p. 1950-1960.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Chen, S, Pürerfellner, H, Ouyang, F, Kiuchi, MG, Meyer, C, Martinek, M, Futyma, P, Zhu, L, Schratter, A, Wang, J, Acou, W-J, Ling, Z, Yin, Y, Liu, S, Sommer, P, Schmidt, B & Chun, JKR 2021, 'Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data', EUROPACE, vol. 23, no. 12, pp. 1950-1960. https://doi.org/10.1093/europace/euab185

APA

Chen, S., Pürerfellner, H., Ouyang, F., Kiuchi, M. G., Meyer, C., Martinek, M., Futyma, P., Zhu, L., Schratter, A., Wang, J., Acou, W-J., Ling, Z., Yin, Y., Liu, S., Sommer, P., Schmidt, B., & Chun, J. K. R. (2021). Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data. EUROPACE, 23(12), 1950-1960. https://doi.org/10.1093/europace/euab185

Vancouver

Chen S, Pürerfellner H, Ouyang F, Kiuchi MG, Meyer C, Martinek M et al. Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data. EUROPACE. 2021 Dec 7;23(12):1950-1960. https://doi.org/10.1093/europace/euab185

Bibtex

@article{a61e44aa48de4b48a2cd04c2bb6d23dd,

title = "Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data",

abstract = "AIMS: Catheter ablation (CA) is recommended for patients with atrial fibrillation (AF) after failure of antiarrhythmic drugs (AADs). The role of CA as 'initial therapy' for AF is to be determined.METHODS AND RESULTS: Following PRISMA guideline an up-to-date pooled analysis of randomized data comparing ablation vs. AADs as first-line therapy for symptomatic AF was performed. The primary outcome was recurrence of atrial tachyarrhythmia. The secondary outcomes were improvement in quality-of-life (QoL) and major adverse events. A total of 997 patients from five randomized trials were enrolled (mean age 57.4 years, 68.6% male patients, 98% paroxysmal AF, mean follow-up 1.4 years). The baseline characteristics were similar between the ablation and AADs group. Overall pooled analysis showed that, as compared with AADs, CA as first-line therapy was associated with significantly higher freedom from arrhythmia recurrence (69% vs. 48%, odds ratio: 0.36, 95% confidence interval: 0.27-0.48, P < 0.001). This significance was maintained in subgroup analyses of 1- and 2-year follow-up (P < 0.001). Catheter ablation was associated with significantly greater improvement in QoL regarding AFEQT score and 36-Item Short-Form Health Survey score. The incidence of serious adverse events between ablation and AADs group (5.6% vs. 4.9%, P = 0.62) was similar.CONCLUSIONS: Catheter ablation as 'initial therapy' was superior to AADs in maintenance of sinus rhythm and improving QoL for patients with symptomatic paroxysmal AF, without increasing risk of serious adverse events.",

author = "Shaojie Chen and Helmut P{\"u}rerfellner and Feifan Ouyang and Kiuchi, {M{\'a}rcio Galindo} and Christian Meyer and Martin Martinek and Piotr Futyma and Lin Zhu and Alexandra Schratter and Jiazhi Wang and Willem-Jan Acou and Zhiyu Ling and Yuehui Yin and Shaowen Liu and Philipp Sommer and Boris Schmidt and Chun, {Julian K R}",

year = "2021",

month = dec,

day = "7",

doi = "10.1093/europace/euab185",

language = "English",

volume = "23",

pages = "1950--1960",

journal = "EUROPACE",

issn = "1099-5129",

publisher = "Oxford University Press",

number = "12",

}

RIS

TY - JOUR

T1 - Catheter ablation vs. antiarrhythmic drugs as 'first-line' initial therapy for atrial fibrillation: a pooled analysis of randomized data

AU - Chen, Shaojie

AU - Pürerfellner, Helmut

AU - Ouyang, Feifan

AU - Kiuchi, Márcio Galindo

AU - Meyer, Christian

AU - Martinek, Martin

AU - Futyma, Piotr

AU - Zhu, Lin

AU - Schratter, Alexandra

AU - Wang, Jiazhi

AU - Acou, Willem-Jan

AU - Ling, Zhiyu

AU - Yin, Yuehui

AU - Liu, Shaowen

AU - Sommer, Philipp

AU - Schmidt, Boris

AU - Chun, Julian K R

PY - 2021/12/7

Y1 - 2021/12/7

N2 - AIMS: Catheter ablation (CA) is recommended for patients with atrial fibrillation (AF) after failure of antiarrhythmic drugs (AADs). The role of CA as 'initial therapy' for AF is to be determined.METHODS AND RESULTS: Following PRISMA guideline an up-to-date pooled analysis of randomized data comparing ablation vs. AADs as first-line therapy for symptomatic AF was performed. The primary outcome was recurrence of atrial tachyarrhythmia. The secondary outcomes were improvement in quality-of-life (QoL) and major adverse events. A total of 997 patients from five randomized trials were enrolled (mean age 57.4 years, 68.6% male patients, 98% paroxysmal AF, mean follow-up 1.4 years). The baseline characteristics were similar between the ablation and AADs group. Overall pooled analysis showed that, as compared with AADs, CA as first-line therapy was associated with significantly higher freedom from arrhythmia recurrence (69% vs. 48%, odds ratio: 0.36, 95% confidence interval: 0.27-0.48, P < 0.001). This significance was maintained in subgroup analyses of 1- and 2-year follow-up (P < 0.001). Catheter ablation was associated with significantly greater improvement in QoL regarding AFEQT score and 36-Item Short-Form Health Survey score. The incidence of serious adverse events between ablation and AADs group (5.6% vs. 4.9%, P = 0.62) was similar.CONCLUSIONS: Catheter ablation as 'initial therapy' was superior to AADs in maintenance of sinus rhythm and improving QoL for patients with symptomatic paroxysmal AF, without increasing risk of serious adverse events.

AB - AIMS: Catheter ablation (CA) is recommended for patients with atrial fibrillation (AF) after failure of antiarrhythmic drugs (AADs). The role of CA as 'initial therapy' for AF is to be determined.METHODS AND RESULTS: Following PRISMA guideline an up-to-date pooled analysis of randomized data comparing ablation vs. AADs as first-line therapy for symptomatic AF was performed. The primary outcome was recurrence of atrial tachyarrhythmia. The secondary outcomes were improvement in quality-of-life (QoL) and major adverse events. A total of 997 patients from five randomized trials were enrolled (mean age 57.4 years, 68.6% male patients, 98% paroxysmal AF, mean follow-up 1.4 years). The baseline characteristics were similar between the ablation and AADs group. Overall pooled analysis showed that, as compared with AADs, CA as first-line therapy was associated with significantly higher freedom from arrhythmia recurrence (69% vs. 48%, odds ratio: 0.36, 95% confidence interval: 0.27-0.48, P < 0.001). This significance was maintained in subgroup analyses of 1- and 2-year follow-up (P < 0.001). Catheter ablation was associated with significantly greater improvement in QoL regarding AFEQT score and 36-Item Short-Form Health Survey score. The incidence of serious adverse events between ablation and AADs group (5.6% vs. 4.9%, P = 0.62) was similar.CONCLUSIONS: Catheter ablation as 'initial therapy' was superior to AADs in maintenance of sinus rhythm and improving QoL for patients with symptomatic paroxysmal AF, without increasing risk of serious adverse events.

U2 - 10.1093/europace/euab185

DO - 10.1093/europace/euab185

M3 - SCORING: Journal article

C2 - 34405878

VL - 23

SP - 1950

EP - 1960

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 12

ER -