Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. Wazni, O., Marrouche, N., Martin, D., 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. JAMA, 293(21):2634--2640, June, 2005.
  author =       "O.M. Wazni and N.F. Marrouche and D.O. Martin and A.
                 Verma and M. Bhargava and W. Saliba and D. Bash and R.
                 Schweikert and J. Brachmann and J. Gunther and K.
                 Gutleben and E. Pisano and D. Potenza and R. Fanelli
                 and A. Raviele and S. Themistoclakis and A. Rossillo
                 and A. Bonso and A. Natale",
  title =        "Radiofrequency ablation vs antiarrhythmic drugs as
                 first-line treatment of symptomatic atrial
                 fibrillation: a randomized trial.",
  journal =      "JAMA",
  year =         "2005",
  month =        jun,
  volume =       "293",
  number =       "21",
  pages =        "2634--2640",
  robnote =      "afib 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.",
  bibdate =      "Thu Jun 28 00:49:02 2007",

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