{"id":27936,"date":"2020-11-19T09:09:25","date_gmt":"2020-11-19T09:09:25","guid":{"rendered":"https:\/\/bengalnewstimes.com\/?p=27936"},"modified":"2020-11-19T09:09:25","modified_gmt":"2020-11-19T09:09:25","slug":"is-ablation-the-best-choice-for-a-fib","status":"publish","type":"post","link":"https:\/\/bengalnewstimes.com\/?p=27936","title":{"rendered":"Is Ablation the Best Choice for A-Fib?"},"content":{"rendered":"

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\"NewsBy Amy Norton HealthDay Reporter<\/p>\n

WEDNESDAY, Nov. 18, 2020<\/p>\n

A procedure that freezes bits of heart<\/a> tissue may be a better option than medication for people with atrial fibrillation<\/a> (a-fib<\/a>, or AF), two clinical trials<\/a> have found.<\/p>\n

A-fib<\/a> is a common heart<\/a> arrhythmia<\/a> in which the organ’s upper chambers (the atria) beat erratically. Though it is not immediately life-threatening, over time it can lead to complications like heart failure<\/a>, or blood clots<\/a> that cause a stroke<\/a>.<\/p>\n

Right now, the standard first-line treatment is medication, said Dr. Jason Andrade, lead researcher on one of the new studies.<\/p>\n

Those drugs<\/a> help control the heart’s rate and rhythm. If they fail to do that, patients may move on to another option called ablation. It’s a minimally invasive procedure in which doctors use heat or cold<\/a> to destroy bits of heart tissue that are generating the faulty electrical signal causing the arrhythmia<\/a>.<\/p>\n

The two new trials challenged the notion that ablation should only be a second option.<\/p>\n

“The approach with medications is largely treating a symptom,” said Andrade, who directs the Atrial Fibrillation<\/a> Clinic at Vancouver General Hospital in British Columbia, Canada. “If we start with an ablation, we may be able to fix atrial fibrillation<\/a> early in its course, which potentially means reducing the risk of stroke<\/a> and other heart problems down the road.”<\/p>\n

His team found that ablation was, in fact, a better first-line treatment.<\/p>\n

A-fib<\/a> patients who underwent ablation were half as likely to have an arrhythmia episode in the following year compared to patients on medication. And they were 61% less likely to have an episode that caused symptoms.<\/p>\n

The findings were simultaneously published Nov. 16 in the New England Journal of Medicine<\/em> and reported at an online meeting of the American Heart Association.<\/p>\n

“Ablation is more successful than medication for AF, though neither is 100%,” said Dr. Nieca Goldberg, an AHA spokeswoman and cardiologist at NYU Langone Health in New York City.<\/p>\n

She noted that longer-term results are still needed, since trial patients were followed for only a year. “But I don’t think medication will become any more effective over time,” Goldberg added.<\/p>\n

The study involved specific a-fib<\/a> patients: All 303 had paroxysmal a-fib<\/a>, in which arrhythmia episodes crop up periodically. (A-fib<\/a> can also be persistent or permanent.) In addition, all patients had symptoms, such as heart palpitations<\/a>, dizziness<\/a> and shortness of breath<\/a>. (A-fib can also happen “silently,” with no noticeable symptoms.)<\/p>\n

Andrade’s team randomly assigned half of the patients to take standard rhythm-controlling medication. The other half underwent cryoballoon ablation — in which a balloon-tipped catheter is threaded into the heart, then releases liquid nitrogen to freeze the tissue causing the a-fib.<\/p>\n

Over the next year, 43% of those patients had an arrhythmia recurrence, versus 68% of patients on medication. And only 11% of ablation patients had an episode that caused symptoms — compared with 26% of those on drug therapy.<\/p>\n

“Patients undergoing ablation as a first-line therapy had a significant improvement in multiple measures of quality of life and were much more likely to be asymptomatic,” Andrade said.<\/p>\n

A separate trial, reported in the same journal and meeting, found similar results.<\/p>\n

It included 203 U.S. patients with previously untreated paroxysmal a-fib. After one year, 75% of those treated with cryoballoon ablation were a-fib-free, compared to 45% of patients on medication.<\/p>\n

In the Canadian trial, five ablation patients had a serious side effect: Andrade said three had temporary paralysis<\/a> in a nerve that controls the diaphragm<\/a>; the other two developed a slow heart rate that required a pacemaker<\/a> implant. That also happened to two patients on medication.<\/p>\n


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QUESTION<\/h4>\n


\n Atrial fibrillation is a(n) …<\/span>
\n See Answer<\/span>
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The findings do not mean ablation should be the first treatment for everyone, Goldberg said.<\/p>\n

“I think patients should be aware there are different treatment options for AF,” she said. “And it’s really important to discuss all of them with your doctor.”<\/p>\n

As for availability, Andrade said cryoballoon ablation is “pretty widespread” at this point — having been used for over decade.<\/p>\n

In the United States, atrial fibrillation<\/a> affects 3 million to 6 million people, according to the U.S. Centers for Disease Control and Prevention<\/a>. About 40% have the paroxysmal form.<\/p>\n

Andrade said some studies have found cryoablation to be effective for persistent a-fib, too.<\/p>\n

The procedure does not, however, free a-fib patients from taking clot-preventing drugs<\/a>. That decision, Goldberg said, is based on people’s risk factors for having a stroke<\/a>.<\/p>\n

More information<\/strong><\/p>\n

The American Heart Association has more on atrial fibrillation treatment<\/a>.<\/p>\n

SOURCES: Jason Andrade, MD, director, Atrial Fibrillation<\/a> Clinic, Vancouver General Hospital, and associate professor, University of British Columbia, Vancouver, Canada; Nieca Goldberg, MD, cardiologist, and medical director, Joan H. Tisch Center for Women’s Health<\/a>, NYU Langone Health, New York City; New England Journal of Medicine, <\/em>online, Nov. 16, 2020, and presentation, American Heart Association Scientific Sessions, online<\/p>\n

\"MedicalNews\"
Copyright \u00a9 2020 HealthDay. All rights reserved.<\/p>\n


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