Cryoblation as first-line treatment of new-onset atrial fibrillation?

Key PointsThe simultaneously published Early Aggressive Invasive Intervention for Atrial Fibrillation (EARLY-AF)1 and Cryoballon Catheter Ablation in Antiarrhythmic Drug Na ïve Paroxysmal Atrial Fibrillation (STOP AF First)2 are multicentre, open-label, randomized trials aimed at investigating the safety and efficacy of cryoablation as first-line therapy in naive atrial fibrillation (AF).Patients (n = 303 in EARLY-AF1 andn = 203 in STOP AF First2) with untreated symptomatic paroxysmal atrial fibrillation were randomized to receive Class I or III antiarrhythmic drugs or pulmonary vein isolation with cryoballoon.The primary end-point was recurrence of any atrial tachyarrhythmia between 91 (after the blanking period of 90 days) and 365 days, as documented by implantable cardiac monitoring device in EARLY-AF1 and treatment success at 12-lead electrocardiography performed at 1, 3, 6, and 12 months, and 24-h ambulatory monitoring at 6 and 12 months in STOP AF First.2In EARLY-AF,1 a recurrence of atrial tachyarrhythmia at 1 year occurred in 66 of 154 patients (42.9%) in the cryoablation group and in 101 of 149 patients (67.8%) assigned to receive antiarrhythmic drugs [hazard ratio, 0.48; 95% confidence interval (CI), 0.35 –0.66;P< 0.001]. Symptomatic atrial tachyarrhythmia recurred in 11.0% of the patients who underwent ablation and in 26.2% of those who received antiarrhythmic drugs (hazard ratio, 0.39; 95% CI, 0.22 –0.68).In STOP AF First,2 treatment success at 12 months w...
Source: European Heart Journal - Category: Cardiology Source Type: research