EP News: Clinical

Piccini et al (J Am Coll Cardiol 2013;61:1998, PMID 23500298) investigated the outcomes following cardioversion (CV) or catheter ablation in patients with atrial fibrillation (AF) treated with warfarin or rivaroxaban. Over a median follow-up of 2.1 years, 143 patients underwent electrical CV, 142 underwent pharmacologic CV, and 79 underwent catheter ablation. The overall incidence of CV or AF ablation was 1.45 per 100 patient-years (n = 321; 1.44 [n = 161] in the warfarin arm and 1.46 [n = 160] in the rivaroxaban arm. The long-term incidence of stroke or systemic embolism (hazard ratio [HR] 1.38), cardiovascular death (HR 1.57), and death from all causes (HR 1.75) were not different before and after CV or AF ablation. Hospitalization increased after CV or AF ablation (HR 2.01), but there was no evidence of a differential effect by randomized treatment (P value for interaction = .58). The incidences of stroke or systemic embolism (1.88% vs 1.86%) and death (1.88% vs 3.73%) were similar in the rivaroxaban-treated and warfarin-treated groups. The authors conclude that despite an increase in hospitalization, there were no differences in long-term stroke rates or survival following CV or AF ablation.

Source: Heart Rhythm - July 1, 2013 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News--Associate Editors: Peng-Sheng Chen and N.A. Mark Estes III Source Type: research