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 .
The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy.
OBJECTIVES We sought to assess the impact of  intermittent atrial fibrillation ( AF ) on health-related quality of life ( QoL ) . BACKGROUND Intermittent AF is a common condition with little data on health-related QoL question naires to guide investigational therapies . METHODS Out patients from four centers , with documented AF ( n = 152 ) , completed vali date d QoL question naires ( Medical Outcomes Study Short Form 36 [ SF-36 ] , Specific Activity , Symptom Checklist , Illness Intrusiveness and University of Toronto AF Severity Scales ) . Comparison groups were made up of healthy individuals ( n = 47 ) and four cardiac control groups : published ( n = 78 ) and created for study ( n = 69 ) percutaneous transluminal coronary angioplasty ( PTCA ) ; published heart failure ( n = 216 ) and published postmyocardial infa rct ion ( MI ) ( n = 107 ) . RESULTS Across all domains of the SF-36 , AF patients reported substantially worse QoL than healthy controls ( 1.3 to 2.0 st and ard deviation units ) , with scores of 24 % , 23 % , 16 % and 30 % lower than healthy individuals on measures of physical and social functioning , mental and general health , respectively ( all p < 0.001 ) . Patients with AF were either significantly worse ( p < 0.05 , published controls ) or as impaired ( study controls ) as either PTCA or post-MI patients on all domains of the SF-36 and the same as heart failure controls on SF-36 psychological subscales . Patients with AF were as impaired or worse than study PTCA controls on measures of illness intrusiveness , activity limitations and symptoms . Associations between objective disease indexes and subjective QoL measures had poor correlations and accounted for < 6 % of the total variability in QoL scores . CONCLUSIONS Quality of life is as impaired in patients with intermittent AF as in patients with significant structural heart disease . Patients ' perception of QoL is not dependent on the objective measures of disease severity that are usually employed
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 .