The DOI matches its Crossref record; 128 of the 128 references it cites were found in a registry or an index.
Treatment of Atrial Fibrillation With Antiarrhythmic Drugs or Radiofrequency Ablation: Two Systematic Literature Reviews and Meta-Analyses
Abstract
BACKGROUND: Although radiofrequency catheter ablation (RFA) has evolved from an experimental procedure to an important treatment option for atrial fibrillation, the relative safety and efficacy of catheter ablation relative to that of antiarrhythmic drug (AAD) therapy has not been established. METHODS AND RESULTS: Two separate systematic reviews were conducted: one on RFA and the other on AAD to provide accurate and broadly representative estimates of the clinical efficacy and safety of both therapies in the treatment of atrial fibrillation. Electronic searches were conducted in EMBASE and MEDLINE from 1990 to 2007. For the RFA review, all study designs were accepted. For the AAD review, articles were limited to prospective studies on the following drugs of interest: amiodarone, dofetilide, sotalol, flecainide, and propafenone. Data were extracted by 1 reviewer, with a second reviewer performing independent confirmation of extracted data. Sixty-three RFA and 34 AAD studies were included in the reviews. Patients enrolled in RFA studies tended to be younger (mean age, 55 versus 62 years), had longer duration of atrial fibrillation (6.0 versus 3.1 years), and had failed a greater number of prior drug trials (2.6 versus 1.7). The single-procedure success rate of ablation off AAD therapy was 57% (95% CI, 50% to 64%), the multiple procedure success rate off AAD was 71% (95% CI, 65% to 77%), and the multiple procedure success rate on AAD or with unknown AAD usage was 77% (95% CI, 73% to 81%). In comparison, the success rate for AAD therapy was 52% (95% CI, 47% to 57%). A major complication of catheter ablation occurred in 4.9% of patients. Adverse events for AAD studies, although more common (30% versus 5%), were less severe. CONCLUSIONS: Studies of RFA for treatment of atrial fibrillation report higher efficacy rates than do studies of AAD therapy and a lower rate of complications.
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In the citing paper
“Catheter ablation of AF is effective in restoring and maintaining sinus rhythm in patients with symptomatic paroxysmal, persistent, and probably long-standing persistent AF -in general as second-line treatment after failure of or intolerance to antiarrhythmic drug therapy.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“In such patients, catheter ablation is more effective than antiarrhythmic drug therapy.185,586,713,[717][718][719][720]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“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 drugs.586,713,727,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“Most patients require more than one procedure to achieve symptom control.713,726,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“The rhythm outcome after catheter ablation of AF is difficult to predict in individual patients.173,227,713,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“Sinus rhythm without severely symptomatic recurrences of AF is found in up to 70% of patients with paroxysmal AF, and around 50% in persistent AF. 713,728,735,1042”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
In the citing paper
“a meta-analysis of the available (weak) evidence suggests slightly better prevention of recurrent AF in patients treated with antiarrhythmic drugs after catheter ablation.713”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [713]
Citations
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Research works printed but not linked: 1
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Circulation: Arrhythmia and Electrophysiology Editors' Picks
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“With the observation of the actively firing trigger originating from within the pulmonary veins (PVs), ablation strategies have focused at least in patients with paroxysmal AF on complete isolation of the PVs.1,2 However, wide area encircling lines around both the superior and inferior PVs (ipsilateral) were proven to…”
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Questionable levels of evidence in new atrial fibrillation guidelines? Reply
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“At 2 years, the difference was significant in favour of CA. Symptomatic AF occurred in 6.8% of CA patients vs. in 16.2% in drug-treated patients.”
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“The cornerstone of AF ablation is pulmonary vein isolation (PVI) with continuous lesions around the veins in the antrum of the left atrium [6].”
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Biophysics and Clinical Applications of Cryoablation
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Metadata
- Authors
- Calkins, H., Reynolds, M. R., Spector, P., Sondhi, M., Xu, Y., Martin, A., Williams, C. J., & Sledge, I.
- Affiliations
- University of Vermont (US)
- Venue
- Circulation Arrhythmia and Electrophysiology
- Published
- 2009-08
- Volume
- 2
- Issue
- 4
- Pages
- 349-361
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- OpenAlex
- W2020741490
- Cited by
- 847
- References
- 128
- Citations by year
- 2026: 19 · 2025: 29 · 2024: 42 · 2023: 33 · 2022: 38 · 2021: 48 · 2020: 35 · 2019: 37 · 2018: 43 · 2017: 54 · 2016: 62 · 2015: 63 · 2014: 72 · 2013: 69 · 2012: 74
- FWCI
- 43.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Arrhythmia and Electrophysiology (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 catheter ablation, antiarrhythmic drugs, amiodarone, dofetilide, sotalol, flecainide, propafenone, treatment efficacy, procedural complications, ablation success rate
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Catheter Ablation
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