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Therapeutics
Pulmonary vein isolation was better than antiarrhythmic drugs for symptomatic atrial fibrillation

https://doi.org/10.1136/ebm.11.1.16

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    Wazni OM, Marrouche NF, Martin DO, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005;293:2634–40.
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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 ★★★★★★★

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    {concealed}*.†

    Embedded ImageBlinding:

    {unblinded}*.†

    Embedded ImageFollow up period:

    1 year.

    Embedded ImageSetting:

    44 clinical centres in Italy and 26 clinical centres in Germany.

    Embedded ImagePatients:

    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.

    Embedded ImageIntervention:

    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 …

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    Footnotes

    • ↵* Information provided by author.

    • ↵† See glossary.

    • For correspondence: Dr A Natale, Cleveland Clinic Foundation, Cleveland, OH, USA. natalea{at}ccf.org

    • Source of funding: Acuson (division of Siemens Medical Solutions).

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      BMJ Evidence-Based Medicine 2006; 11 31-31 Published Online First: 30 Jan 2006. doi: 10.1136/ebm.11.1.31-a