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Q In patients with symptomatic atrial fibrillation (AF), is pulmonary vein isolation (PVI) with radiofrequency ablation more effective than antiarrhythmic drugs as first line treatment?
Clinical impact ratings Internal medicine ★★★★★★☆ Cardiology ★★★★★★★
randomised controlled trial.
Follow up period:
44 clinical centres in Italy and 26 clinical centres in Germany.
70 patients who were 18–75 years of age and had experienced monthly symptomatic AF ⩾3 months. Exclusion criteria included previous history of AF or AF ablation, previous treatment with antiarrhythmic drugs, and contraindication to long term anticoagulation.
33 patients were allocated to PVI with radiofrequency ablation (all 4 pulmonary veins were isolated) and were given ⩾3 months of warfarin, beginning on the evening of PVI (target international normalised ratio [INR] of 2–3). If patients …