New post up on Medscape/Cardiology: Ablation versus medicine as an intitial strategy for treating AF

Earlier this month I promised to put together teaching points from the Rich Peverley story. His was an interesting case of  sudden collapse that likely occurred as a result of atrial fibrillation therapy rather than atrial fibrillation itself. This was my original report: Important lessons from the collapse of NHL player Rich Peverley (BTW: It set a blog record for pageviews on a single day.) This was the follow-up post in which I discuss the fact that atrial fibrillation featured prominently in the mishap: Atrial fibrillation features prominently in Rich Peverley collapse Mr Peverley and his doctors announced a great deal of details about his treatment. The case presented an opportunity to discuss the complicated decision-making in treating AF, especially the initial approach to rhythm control. I put together a summary post for the Trials and Fibrillations Blog over at Medscape/Cardiology. The 1800-word post (with references) can be broken down into four parts. In the first section, I introduce the case, and the three treatment options that all symptomatic AF patients face: 1. Live with the disease, 2. Take a precarious medicine, 3. Undergo an invasive expensive ablation procedure. In the second section, I review the evidence base comparing ablation v drugs as an initial rhythm-control therapy of AF. There is not much evidence to discuss. And this leads to a great deal of leeway for clinical judgement–e.g. doctoring. In the third section, I offer seven thoughts to con...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs