Progression of Atrial Fibrillation after Cryoablation or Drug Therapy

Andrade, Jason G.; Deyell, Marc W.; Macle, Laurent; Wells, George A.; Bennett, Matthew T.; Essebag, Vidal; Champagne, Jean; Roux, Jean‐François; Yung, Derek; Skanes, Allan C.; Khaykin, Yaariv; Morillo, Carlos A.; Jolly, Umjeet; Novak, Paul; Lockwood, Evan; Amit, Guy; Angaran, Paul; Sapp, John L.; Wardell, Stephan; Lauck, Sandra; Cadrin‐Tourigny, Julia; Kochhäuser, Simon; Verma, Atul

doi:10.1056/nejmoa2212540

Cited by 131 publications

(77 citation statements)

References 25 publications

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“…This growth is likely attributable to the combination of increasing disease burden, procedural availability and efficiency, training programs that provide more exposure to and training in complex ablation of both atrial and ventricular arrhythmias, and evidence supporting invasive management earlier. 3 , 12 , 13 , 14 As treatments for other structural heart disease improve, including those for heart failure and coronary artery disease, need for arrhythmia management has increased (including both AF and VT) as people live longer with coexistent cardiovascular disease. Additionally, over the period studied several randomized clinical trials of catheter ablation for AF and VT demonstrated favorable results for the use of these procedures, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Contemporary trends in cardiac electrophysiology procedures in the United States, and impact of a global pandemic

Scott¹,

Baykaner²,

Bunch³

et al. 2023

Heart Rhythm O2

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Section: Discussionmentioning

confidence: 99%

“…Lastly, contemporary and emerging evidence supporting earlier arrhythmia interventions has the potential to increase utilization of electrophysiology procedures. 2 , 3 Despite these circumstances, there remains little data on the trends in rates of EP procedures in the US, nor the clinicians performing them.…”

Section: Introductionmentioning

confidence: 99%

Contemporary trends in cardiac electrophysiology procedures in the United States, and impact of a global pandemic

Scott¹,

Baykaner²,

Bunch³

et al. 2023

Heart Rhythm O2

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“…10 Although most clinicians may use drugs as their first choice for rhythm control in AF compared with ablation, emerging data support ablation as first line of therapy, and ablation is undisputedly superior in previous drug failure. 11 , 12 , 13 …”

Section: Remaining Clinical Use Of Antiarrhythmic Drugsmentioning

confidence: 99%

“…Most recently, catheter ablation as a first-line treatment for paroxysmal AF has been shown to have not only improved rhythm control 11 , 29 but also reduced progression to persistent AF on long-term follow-up. 13 …”

Section: The Rise Of Catheter Ablation and Device Therapies And Decli...mentioning

confidence: 99%

The Future of Antiarrhythmic Drug Therapy: Will Drugs Be Entirely Replaced by Procedures?

Valderrábano

2022

Methodist DeBakey Cardiovascular Journal

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Antiarrhythmic drug therapy has traditionally been centered in modulating the generation or propagation of the cardiac action potential by drugs acting on membrane ion channels. The history of this approach has been disappointing, marked by catastrophic failures such as those of sodium channel blockers or sotalol to treat ventricular arrhythmias in the setting of structural cardiomyopathies, which led to increased mortality, and by modest clinical efficacy in paroxysmal atrial fibrillation. As catheter ablation has become an established effective therapy for most tachyarrhythmias, membrane-acting drugs have been relegated to symptomatic control of benign arrhythmias in normal hearts or to adjunctive treatments of ventricular tachycardia (combined with catheter ablation and cardiac defibrillators) in the setting of cardiomyopathies. Novel targets of biological modulation of arrhythmia substrates beyond the membrane potential appear promising and could represent future opportunities for arrhythmia pharmacotherapy.

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“…While rarely life threatening, atrial fibrillation (AF) significantly impairs functional capacity and quality of life, with high rates of secondary healthcare utilisation [2]. Moreover, AF is a progressive disease, transitioning from an isolated electrical disorder to a sustained arrhythmic condition through a combination of structural, electrical, and contractile remodelling [3].…”

mentioning

confidence: 99%