Guidelines prescribe that one or more antiarrhythmic medications be tested before catheter ablation is considered in patients with atrial fibrillation. First-line ablation could be more effective in preserving sinus rhythm, we’ve discovered. Severe adverse effects resulted in 5 patients who underwent ablation and 6 patients who prescribed antiarrhythmic drug treatment. Patients undergoing initial care for symptomatic, paroxysmal atrial fibrillation had a slightly lower risk of recurrence with catheter cryoballoon ablation than with antiarrHythmicDrug, as measured by continuous heart rhythm testing. The median ratio of time of atrial fibrillation was 0 per cent (interquartile scale, 0 to 0.08) with ablation and 0.13 per cent with drug treatment compared to 0.60 per cent with ablated therapy.
Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. https://www.nejm.org/doi/full/10.1056/NEJMoa2029980