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Wednesday, December 30, 2009 9:00 AM
Untitled Document

Research News: A New Guide Compares Atrial Fibrillation Treatments

Debra: More than 2.2 million American adults suffer from atrial fibrillation, an irregular heart rhythm that puts them at risk for heart failure, blood clots, or strokes. A new guide for clinicians summarizes the available evidence from 120 research studies, and compares the use of medicine to the use of radiofrequency ablation for treating atrial fibrillation. Dr. Elise Berliner from the Agency for Healthcare Research and Quality joins us to talk about the guide. Welcome.

Dr. Berliner: Thank you.

Debra: Dr. Berliner, tell us about this guide and why clinicians might find it useful.

Dr. Berliner: The guide could be particularly useful for primary care doctors who have identified patients with atrial fibrillation and now want to talk to them about treatment options. Some patients with atrial fibrillation may be adequately treated with anti-arrhythmic drugs - or AADs. But an alternative method for restoring normal cardiac rhythm that is getting increasing use is radiofrequency ablation. So this guide is helpful for clinicians who are discussing options with their patients about the benefits and risks of using radiofrequency ablation to treat atrial fibrillation.

Debra: Should radiofrequency ablation be considered as the first treatment for patients?

Dr. Berliner: It’s important that clinicians know that, currently, we don’t have enough evidence to determine the effectiveness of radiofrequency ablation as a first-line therapy compared with anti-arrhythmic drugs. Most trials examined the effectiveness of radiofrequency ablation as a second-line therapy - with patients who had failed at least one previous trial of AADs. It is important to understand that point when considering this option.

Debra: And what are the risks of this procedure?

Dr. Berliner: The most common adverse events are bleeding or pain at the catheter insertion site. Other risks include pulmonary vein stenosis, a narrowing of the pulmonary vein, which is not uncommon, but usually has no symptoms and does not require treatment. Also, about 1 percent of patients have cardiac tamponade. These patients may require periocardiocentesis using a needle to remove fluid from the pericardial sac or they could require surgery. Rarely, about 1 percent of patients suffer a stroke.

Debra: Thank you, Dr. Berliner.

Dr. Berliner: You’re welcome.

Debra: A free copy of the guide, called "Radiofrequency Ablation for Atrial Fibrillation: Clinician’s Guide," is available online at effectivehealthcare.ahrq.gov.

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