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TEHRAN, Mar 17 - Two new trials may have the answer. Researchers say ablation and medicines perform similarly in protecting a-fib patients from stroke, death and other complications.
TEHRAN, Young Journalists Club (YJC) -However, ablation may beat out drug therapy over the long term, reducing recurrences of a-fib and related hospitalizations for years to come, researchers say.
Patients who got ablation -- where a catheter is used to tweak the heart muscle cells responsible for the arrhythmia -- also seemed to have less shortness of breath, less fatigue and all-around better quality of life five years later, compared to those who got drug therapy alone.
The quality-of-life trial, "because of its size and duration, provides extraordinary new data regarding the patient's perspective," said Dr. Yves Rosenberg.
He was program officer for the study, and is also chief of the Atherothrombosis and Coronary Artery Disease Branch at the U.S. National Heart, Lung, and Blood Institute (NHLBI), which helped fund both trials.
A cardiologist who reviewed the findings said the data should reassure patients.
"I think the takeaway from this study is that catheter ablation is effective and safe for treating atrial fibrillation," said Dr. Laurence Epstein, who directs electrophysiology at Northwell Health in Manhasset, N.Y.
"If you have atrial fibrillation and are symptomatic, ablation is a reasonable first-line option, as opposed to taking drugs," he said.
Treatment pros and cons
According to the NHLBI, a-fib affects at least 2.7 million Americans and can lead to stroke, heart failure, and even mental impairment. Symptoms include rapid heart palpitations ("flip-flops" or skips); fatigue; shortness of breath, and difficulty doing physical activity.
"Since current drug therapies often have limited effectiveness in controlling atrial fibrillation, it is very important to understand whether ablation, an invasive procedure, yields better outcomes," Dr. David Goff, director in the division of cardiovascular sciences at the NHLBI, said in an institute news release.
As Epstein explained, during ablation, "long catheters -- wires with electrodes on them -- are placed into the heart via the large veins in the groin. Radio waves are delivered from the catheter to the heart muscle, which causes heat and the controlled destruction of the muscle cells responsible for causing atrial fibrillation."
Sometimes ablation is performed using tiny balloons that freeze the heart muscle to create the same effect.
Of course, no treatment is foolproof. "Depending on the patient the procedure can be as effective as 80-90 percent," Epstein said, "but in others, at best, 50 percent."
Many other patients get drug therapy alone to control the aberrant heart rhythm. But Epstein said outcomes are often "disappointing because the drugs do not work that well and that they can cause 'pro-arrhythmia.'
Source:upi
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