RAAFT-2 (Radiofrequency Ablation vsAntiarrhythmic Drugs as First-LineTherapy of Atrial Fibrillation)
RAAFT-2 (Radiofrequency Ablation vs AntiarrhythmicDrugs as First-Line Therapy of Atrial Fibrillation)C Morillo (Hamilton H...
RAAFT-2: Results• In the ablation group, 15.2% required additional ablation; seven patients  (10.6%) went on AAD therapy• ...
RAAFT-2: Commentary*"To be able to claim victory with ablation, you really need to monitor these patientsvery judiciously....
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RAAFT-2 trial - Summary & Results

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A Study on Radiofrequency Ablation vs Antiarrhythmic Drugs as First-Line Therapy of Atrial Fibrillation (RAAFT-2) to determine whether catheter-based pulmonary vein isolation is superior to antiarrhythmic drug (AAD) as first-line in patients with symptomatic paroxysmal recurrent AF not previously treated with therapeutic foses of AAD.

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RAAFT-2 trial - Summary & Results

  1. 1. RAAFT-2 (Radiofrequency Ablation vsAntiarrhythmic Drugs as First-LineTherapy of Atrial Fibrillation)
  2. 2. RAAFT-2 (Radiofrequency Ablation vs AntiarrhythmicDrugs as First-Line Therapy of Atrial Fibrillation)C Morillo (Hamilton Health Sciences-McMaster University, ON)Heart Rhythm Society 2012 Scientific Sessions• A study to determine whether catheter-based pulmonary vein isolation is superior to antiarrhythmic drugs (AAD) as first-line therapy in patients with symptomatic paroxysmal recurrent AF not previously treated with therapeutic doses of AAD• Population and design: 127 patients not previously treated with AAD randomized either to undergo RF ablation within 4 to 6 weeks or to initiate AAD, with 90 days allowed for titrating doses Patients had normal systolic function, and none had hypertension or heart failure; all were followed with transtelephonic monitoring (TTM)• Primary outcome: Time to first episode of symptomatic atrial fibrillationAAD=antiarrhythmic drug; AF= atrial fibrillation; TTM=transtelephonic monitoring;RF=radiofrequency
  3. 3. RAAFT-2: Results• In the ablation group, 15.2% required additional ablation; seven patients (10.6%) went on AAD therapy• In the AAD group, 59% had to discontinue at least one antiarrhythmic drug and 29 patients (47.5%) underwent catheter ablation during the follow-upRecurrence rates at two years for symptomatic or asymptomatic AF, atrial flutter, oratrial tachycardia lasting >30 secondsEnd point Ablation, n=66 (%) AAD, n=61 (%) HR (95% CI), pRecurrence of AF, atrial flutter, or atrial tachycardia 55 72 0.56 (0.35–0.90), 0.02Symptomatic recurrence of AF, atrial flutter, or atrial tachycardia 47 59 0.56 (0.33–0.95), 0.03Symptomatic AF only 41 58 0.52 (0.30–0.89), 0.01Recurrence by clinical criteria only 24 31 0.86 (0.42–1.72), 0.66
  4. 4. RAAFT-2: Commentary*"To be able to claim victory with ablation, you really need to monitor these patientsvery judiciously. . . . These findings support the indication of radiofrequencypulmonary vein isolation as first-line therapy in patients with paroxysmal atrialfibrillation." - Dr Carlos Morillo*All comments from RAAFT 2: Catheter ablation can be first line of defense against paroxysmal AF(http://www.theheart.org/article/1397545.do)
  5. 5. Become a member of http://www.theheart.org Become a fan on Facebook: http://www.facebook.com/theheartorg Follow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.

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