Clinical Evidence
for Ablation
Innovations in catheter abalation technology have made it possible for more patients to experience relief from disruptive atrial fibrillation symptoms. Discover how abalation has evolved into the safe, effective procedure it is today.

Repeat ablation is necessary for some patients. It doesn’t indicate a failure. Craig Delaughter, M.D., PhD | Electrophysiologist

A post-hoc, on-treatment analysis of the AFFIRM study revealed that use of AADs to restore sinus rhythm increased mortality

5. AFFIRM Study: A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators N Engl J Med 2002; 347:1825-1833, December 5, 2002

6. Bunch TJ. J Gen Intern Med. 26(5):531-7.

A Close Look at AAD Safety

A series of landmark trials (AFFIRM, RACE, STAF, and PIAF) have called into question the long-term safety of AADs.

Currently available AADs are not associated with improved survival, which suggests that any beneficial effects of AADs may be offset by their adverse effects.

A post-hoc analysis of the AFFIRM study reinforced this notion, showing that the presence of sinus rhythm was associated with a significant reduction in mortality, but the use of antiarrhythmic drugs increased mortality by 49%.

AAD Safety

What are the Challenges with AADs?

Medical therapy for the treatment of atrial fibrillation has been described by cardiologists as less than optimal. Patients are often alarmed to find that the medications used to maintain sinus rhythm in patients with atrial fibrillation are often associated with numerous side effects.

2014 ACCF/AHA/HRS Atrial Fibrillation Treatment Guidelines

Did you know that the ACCF/AHA/HRS Atrial Fibrillation Treatment Guidelines have been updated in 2014?

2014 Guidelines for AF management

Understanding the Guidelines Grading System

The current guidelines use a grading schema based on the class of a recommendation and the level of evidence that supports the recommendation.

Class of recommendation indicates the recommendation's strength based on expert consensus review of published study data.

The level of evidence weighs the quality of study data to help inform the recommendation.

Understanding Guidelines

The Evolution of Catheter Ablation

In a short span of time, the technology associated with RF catheter ablation has dramatically improved the precision and the performance of the procedure.

Discover how these advancements enable electrophysiologists to improve the quality and safety of their procedure. In turn, cardiologists are increasingly more confident to refer patients to have RF ablation.

Recommendations for Therapy in the Maintenance of Sinus Rhythm

This useful resource gives an at-a-glance view of the most current expert consensus guidelines for the maintenance of sinus rhythm in patients with atrial fibrillation.

The downloadable tool also features newly updated recommendations for the use of catheter ablation.

Recommendations for Therapy

New Era of Catheter Ablation

The strategy of restoring and maintaining sinus rhythm with antiarrhythmic drugs has been shown to be only partially successful in patients with atrial fibrillation.

Data across 4 landmark studies demonstrate that antiarrhythmic medications used in the rhythm control groups did not result in much higher rates of sinus rhythm compared with the rate control groups.


The Evolution Of Efficacy

Patients asymptomatic, without the use of AADs following RF catheter ablation

Advanced technology, improved techniques, and expert experience have rapidly transformed ablation outcomes for individuals with paroxysmal atrial fibrillation.

*Based on data from an international survey conducted between 1995 and 2002, which included 8,745 patients who underwent a total of 12,830 ablation procedures. Success rates based on median number of 1.5 procedures per patient.

†Based on data from an international survey conducted between 2003 and 2006, which included 16,309 patients who underwent a total of 20,825 ablation procedures. Success rates based on median number of 1.3 procedures per patient.

Cappato R. Circ Arrhythm Electrophysiol. 2010;3:32-38.

Understanding the Role of Repeat Ablation

Discover how electrophysiologists excercise caution to not create collateral tissue damage during the procedure, and how the body's own immune response plays a role in the need for repeat ablation procedures.

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Considering Ablation Earlier

Based on the recent updates to the treatment guidelines for atrial fibrillation, patients who have failed one class 1 or class 2 AAD should be considered for catheter ablation. Because of the potential benefits, these guidelines now encourage treating physicians to refer their drug-refractory Afib patients for catheter ablation sooner than was once recommended.

Improving quality of life through RF catheter ablation

Quality of Life Assessment with change from baseline to 3 months.

Mean quality-of-life scores at 3 months improved significantly in patients treated by RF catheter ablation compared with patients treated with AADs.1

RF catheter ablation is effective in improving quality of life by eliminating arrhythmia-related symptoms such as palpitations, fatigue, and effort intolerance.2

1. Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303(4):333-340.

2. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm. 2012;9(4):632-693. e21.