Nonparoxysmal Afib: is catheter ablation better than antiarrhythmics?

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Takeaway 

  • Taking on the question of which is better for nonparoxysmal Afib, this meta-analysis gives the win to catheter ablation for preventing recurrences, decreasing hospitalizations at 1 y.

Why this matters  

  • Ablation has already shown a clear benefit in paroxysmal Afib, but only 3 trials were available for assessment of its benefits in nonparoxysmal Afib.
  • Current recommendations are radiofrequency ablation in symptomatic nonparoxysmal Afib intractable to medication or for Afib continuous for 1 y; the current results support recommendations.

Key results 

  • All trials used radiofrequency catheter ablation.
  • More ablation patients were arrhythmia free at 1 y vs antiarrhythmic group (69% vs 35%; risk ratio, 1.84).
  • There were less card...