Jonathan Kalman, MBBS, PhD

It is feasible to treat patients with symptomatic atrial fibrillation (AF) with antiarrhythmic drugs (AADs) for at least 1 year without hampering the outcomes of subsequent ablation, according to Jonathan Kalman, MBBS, PhD. This was the main outcome of a prospective, randomised study investigating the timing of ablation in patients with AF, according to Dr. Kalman and colleagues who presented their finding at the 2023 European Heart Rhythm Association (EHRA) in Barcelona, Spain¹.

The researchers conducted a prospective, multi-center study to compare the outcomes of early ablation (<1 month after diagnosis) with optimised AAD plus delayed ablation (12 months post-diagnosis) in patients with AF. In total, 41 patients received early ablation and 48 underwent delayed ablation. The primary outcome was atrial arrhythmia-free survival at 12 months post-ablation.

No difference was measured between the early ablation group and the delayed ablation group with respect to atrial arrhythmia-free survival at 12 months after ablation (43.7% vs 41.4%; P=0.82). Similarly, the two study groups did not differ in terms of atrial arrhythmia burden, symptom severity, or AAD use at 1 year after ablation.

Dr. Kalman and colleagues provided reassuring evidence that, if applicable, patients with symptomatic AF may be treated with AADs for at least 1 year, without negatively influencing the results of subsequent ablation.

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