In people with non-paroxysmal atrial fibrillation , evidence suggests a superiority of RFCA to antiarrhythmic drugs in achieving freedom from atrial arrhythmias , reducing the need for cardioversion , and reducing cardiac-related hospitalisations .
BACKGROUND The optimal rhythm management strategy for people with non-paroxysmal ( persistent or long-st and ing persistent ) atrial fibrilation is currently not well defined .
Antiarrhythmic drugs have been the mainstay of therapy .
But recently , in people who have not responded to antiarrhythmic drugs , the use of ablation ( catheter and surgical ) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications .
However , evidence from r and omised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited .
OBJECTIVES To determine the efficacy and safety of ablation ( catheter and surgical ) in people with non-paroxysmal ( persistent or long-st and ing persistent ) atrial fibrillation compared to antiarrhythmic drugs .
Quality of life and exercise performance in patients in sinus rhythm versus persistent atrial fibrillation: a Veterans Affairs Cooperative Studies Program Substudy.
OBJECTIVES The purpose of this study was to determine quality of life ( QOL ) and exercise performance ( EP ) in patients with persistent atrial fibrillation ( AF ) converted to sinus rhythm ( SR ) compared with those remaining in or reverting to AF . BACKGROUND Restoration of SR in patients with AF improving QOL and EP remains controversial . METHODS Patients with persistent AF were r and omized double-blind to amiodarone , sotalol , or placebo . Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks ( n = 624 ) and 1 year ( n = 556 ) . The QOL ( SF-36 ) , symptom checklist ( SCL ) , specific activity scale ( SAS ) , AF severity scale ( AFSS ) , and EP were assessed . RESULTS Favorable changes were seen in SR patients at 8 weeks in physical functioning ( p < 0.001 ) , physical role limitations ( p = 0.03 ) , general health ( p = 0.002 ) , and vitality ( p < 0.001 ) , and at 1 year in general health ( p = 0.007 ) and social functioning ( p = 0.02 ) . Changes in the scores for SCL severity ( p = 0.01 ) , functional capacity ( p = 0.003 ) , and AFSS symptom burden ( p < 0.001 ) at 8 weeks and in SCL severity ( p < 0.01 ) and AF symptom burden ( p < 0.001 ) at 1 year showed significant improvements in SR versus AF . Symptomatic patients were more likely to have improvement . The EP in SR versus AF was greater from baseline to 8 weeks ( p = 0.01 ) and to 1 year ( p = 0.02 ) . The EP correlated with physical functioning and functional capacity except in the AF group at 1 year . CONCLUSIONS In patients with persistent AF , restoration and maintenance of SR was associated with improvements in QOL measures and EP . There was a strong correlation between QOL measures and EP
In people with non-paroxysmal atrial fibrillation , evidence suggests a superiority of RFCA to antiarrhythmic drugs in achieving freedom from atrial arrhythmias , reducing the need for cardioversion , and reducing cardiac-related hospitalisations .
BACKGROUND The optimal rhythm management strategy for people with non-paroxysmal ( persistent or long-st and ing persistent ) atrial fibrilation is currently not well defined .
Antiarrhythmic drugs have been the mainstay of therapy .
But recently , in people who have not responded to antiarrhythmic drugs , the use of ablation ( catheter and surgical ) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications .
However , evidence from r and omised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited .
OBJECTIVES To determine the efficacy and safety of ablation ( catheter and surgical ) in people with non-paroxysmal ( persistent or long-st and ing persistent ) atrial fibrillation compared to antiarrhythmic drugs .