The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.
Radiofrequency Ablation vs Antiarrhythmic Drugs as First-line Treatment of Symptomatic Atrial Fibrillation: A Randomized Trial
Abstract
CONTEXT: Treatment with antiarrhythmic drugs and anticoagulation is considered first-line therapy in patients with symptomatic atrial fibrillation (AF). Pulmonary vein isolation (PVI) with radiofrequency ablation may cure AF, obviating the need for antiarrhythmic drugs and anticoagulation. OBJECTIVE: To determine whether PVI is feasible as first-line therapy for treating patients with symptomatic AF. DESIGN, SETTING, AND PARTICIPANTS: A multicenter prospective randomized study conducted from December 31, 2001, to July 1, 2002, of 70 patients aged 18 to 75 years who experienced monthly symptomatic AF episodes for at least 3 months and had not been treated with antiarrhythmic drugs. INTERVENTION: Patients were randomized to receive either PVI using radiofrequency ablation (n=33) or antiarrhythmic drug treatment (n=37), with a 1-year follow-up. MAIN OUTCOME MEASURES: Recurrence of AF, hospitalization, and quality of life assessment. RESULTS: Two patients in the antiarrhythmic drug treatment group and 1 patient in the PVI group were lost to follow-up. At the end of 1-year follow-up, 22 (63%) of 35 patients who received antiarrhythmic drugs had at least 1 recurrence of symptomatic AF compared with 4 (13%) of 32 patients who received PVI (P<.001). Hospitalization during 1-year follow-up occurred in 19 (54%) of 35 patients in the antiarrhythmic drug group compared with 3 (9%) of 32 in the PVI group (P<.001). In the antiarrhythmic drug group, the mean (SD) number of AF episodes decreased from 12 (7) to 6 (4), after initiating therapy (P = .01). At 6-month follow-up, the improvement in quality of life of patients in the PVI group was significantly better than the improvement in the antiarrhythmic drug group in 5 subclasses of the Short-Form 36 health survey. There were no thromboembolic events in either group. Asymptomatic mild or moderate pulmonary vein stenosis was documented in 2 (6%) of 32 patients in the PVI group. CONCLUSION: Pulmonary vein isolation appears to be a feasible first-line approach for treating patients with symptomatic AF. Larger studies are needed to confirm its safety and efficacy.
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“Fewer data are available reporting the effectiveness and safety of catheter ablation in patients with persistent or long-standing persistent AF, but all point to lower recurrence rates after catheter ablation compared to antiarrhythmic drug therapy with or without cardioversion.185,717,[723][724][725][726]1039”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [723]
In the citing paper
“Fewer data are available reporting the effectiveness and safety of catheter ablation in patients with persistent or long-standing persistent AF, but all point to lower recurrence rates after catheter ablation compared to antiarrhythmic drug therapy with or without cardioversion.185,717,[723][724][725][726]1039”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [723]
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Cites
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A comparison of rate control and rhythm control in patients with atrial fibrillation
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa021328 · Cited by 4,405
Atrial Fibrillation Begets Atrial Fibrillation
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ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary
Fuster, V., Rydén, L., ASINGER, R. W., Cannom, D. S., Crijns, H. J. G. M., Frye, R. L., Halperin, J. L., Kay, G. N., Klein, W. W., Lévy, S., et al. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01587-x · Cited by 1,362
Cappato, R., Calkins, H. G., Chen, S., Davies, W. D., Iesaka, Y., Kalman, J. M., Kim, Y.-H., Klein, G. J., Packer, D. L., & Skanes, A. C. (2005) · Circulation · doi:10.1161/01.cir.0000157153.30978.67 · Cited by 1,303
The AFFIRM Investigators (2004) · Circulation · doi:10.1161/01.cir.0000121736.16643.11 · Cited by 1,202
Pulmonary Vein Isolation for Paroxysmal and Persistent Atrial Fibrillation
Oral, H., Knight, B. P., Tada, H., Özaydın, M., Chugh, A., Hassan, S. A., Scharf, C., Lai, S. W. K., Greenstein, R., Pelosi, F., et al. (2002) · Circulation · doi:10.1161/hc0902.104712 · Cited by 1,112
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Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström‐Lundqvist, C., Boriani, G., Castella, M., Dan, G.-A., Dilaveris, P., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa612 · Cited by 10,550
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H. G., Cigarroa, J. E., Cleveland, J. C., CONTI, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000041 · Cited by 7,145
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418
“catheter ablation compared to antiarrhythmic drug therapy with or without cardioversion (Web Figure 2).(185,717,723) – 726,1039 In patients who experience symptomatic recurrences of AF despite antiarrhythmic drug therapy, all RCTs showed better sinus rhythm maintenance with catheter ablation than on antiarrhythmic dru…”
Guidelines for the management of atrial fibrillation
Authors/Task Force Members, Camm, A. J., Kirchhof, P. F., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Gelder, I. C. V., Al‐Attar, N., Hindricks, G., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq278 · Cited by 5,924
Metadata
- Authors
- Wazni, O. M., Marrouche, N. F., Martin, D. O., Verma, A., Bhargava, M., Saliba, W., Bash, D., Schweikert, R., Brachmann, J., Gunther, J., Gutleben, K., Pisano, E., Potenza, D., Fanelli, R., Raviele, A., Themistoclakis, S., Rossillo, A., Bonso, A., & Natale, A.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Natale, Andrea
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2005-06-01
- Volume
- 293
- Issue
- 21
- Pages
- 2634
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2154269490
- Cited by
- 1,121
- References
- 39
- Citations by year
- 2026: 18 · 2025: 31 · 2024: 38 · 2023: 29 · 2022: 61 · 2021: 52 · 2020: 45 · 2019: 36 · 2018: 53 · 2017: 40 · 2016: 44 · 2015: 52 · 2014: 69 · 2013: 75 · 2012: 78
- FWCI
- 43.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial fibrillation, radiofrequency ablation, pulmonary vein isolation, antiarrhythmic drugs, first-line therapy, atrial fibrillation recurrence, hospitalization, quality of life, pulmonary vein stenosis, anticoagulation, thromboembolic events, Short Form 36 Health Survey, randomized trial comparison, cost-effectiveness, patient satisfaction
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Middle Aged, Pilot Projects, Prospective Studies, Pulmonary Veins, Quality of Life, Survival Analysis, Treatment Outcome, Catheter Ablation
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