In a new study from UC Davis, researchers find that using catheter-based ablation could reduce the risks of death and stroke in patients with the common form of heart arrhythmia known as atrial fibrillation (AFib).
Ablation is currently only recommended when AFib medications don’t work or aren’t well tolerated.
Part of the hesitation to use ablation earlier and more often is because research so far has produced inconsistent results.
Most of those studies focused on single centers or were controversial in terms of patient selection and cross over.
This study addresses these limitations by evaluating AFib treatment outcomes over a long period of time and for large numbers of multi-ethnic patients with similar health statuses.
It’s estimated that at least 2.7 million Americans have AFib, which is diagnosed when the heart beats inconsistently due to uncoordinated signals between its upper chambers.
The condition can cause lightheadedness, fatigue, shortness of breath and chest pain, and is associated with increased risks of stroke and death.
Medications can help reduce AFib symptoms and risks by controlling heart rate and rhythm and reducing blood clots.
Ablation is a more long-term solution that uses heat or extreme cold to destroy the heart tissue responsible for the faulty electrical signals, reducing the need for rhythm-control medications.
In the study, researchers evaluated medical records from AFib patients hospitalized between 2005 and 2013 in California.
Two groups of about 4,000 each were compared: one that was treated with ablation and another that was not.
The groups were matched in terms of AFib patterns and prior hospitalizations.
Outcomes for both groups were similar in terms of rates of death, ischemic stroke and hemorrhagic stroke within 30 days of hospitalization.
Beyond 30 days, however, the benefits of ablation were apparent:
84 patients in the ablation group died, versus 189 in the control group;
55 patients in the ablation group had ischemic strokes, versus 86 in the control group;
17 patients in the ablation group had hemorrhagic strokes, versus 53 in the control group.
The study confirms the overall short- and long-term safety of ablation as an AFib treatment.
The team said that currently, less than 2% of patients undergo ablation early in the course of AFib when the procedure can be most beneficial.
Their study shows that ablation may be considered as a primary treatment for everyone with the condition.
The study is published in the journal Circulation: Arrhythmia and Electrophysiology.
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