Jacob, Sam, and I recently attended the annual European congress for cardiologists focusing on heart rhythm disorders.
It took place in Paris from April 12-14. Among many interesting presentations, a study from Shanghai (“CEPAF Trial”) stood out, examining the importance of early ablation in patients with persistent atrial fibrillation.
Study on Ablation in Persistent Atrial Fibrillation | CEPAF Trial
For years, we have known that ablation is a safe and effective treatment for paroxysmal atrial fibrillation – episodes that come and go. However, there has been more skepticism regarding persistent atrial fibrillation, which does not resolve spontaneously. Several studies have shown that outcomes are generally less favorable in this group.
Study Design
- A total of 274 patients were randomized to ablation (135 patients) or medical therapy (139 patients).
- All had persistent atrial fibrillation for no more than one year.
- None had received antiarrhythmic drugs such as flecainide or amiodarone prior to inclusion.
- The study was well conducted with long-term heart rhythm monitoring (“Holter monitoring”) at 3, 6, and 12 months.
The primary endpoint was recurrence of atrial fibrillation or other arrhythmias during one year of follow-up.
Results CEPAF Trial
Prosentandel pasienter som ikke opplever episoder med atrieflimmer etter ulike behandlingsmetoder:
Nearly 80% of patients treated with ablation were in normal sinus rhythm after one year, compared to less than 50% in the medical therapy group.
- Quality of life was also significantly higher in the ablation group.
- No complications were reported in patients undergoing ablation.
Conclusion
These are very encouraging results, highlighting the importance of early treatment of atrial fibrillation. This applies to both paroxysmal and persistent forms – perhaps especially persistent AF, where treatment effectiveness declines the longer the condition persists.
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