New Research Reveals Predictors of and Safer Treatment for Atrial Fibrillation
Results of a long-term, prospective study published in the HeartRhythm Journal

FOR IMMEDIATE RELEASE
Contact: Ann-Marie White
Heart Rhythm Society
(202) 464-3476
awhite@hrsonline.org

WASHINGTON, DC — New research reveals age, diabetes and heart failure as independent predictors of atrial fibrillation (AF) progression. The new study published in the November edition of the HeartRhythm Journal, the official journal of the Heart Rhythm Society, also concludes that early catheter ablation rather than antiarrhythmic drug therapy (ADT) reduces AF recurrences, delaying arrhythmia progression in almost all patients. 

The study is the first to prospectively assess the progression of AF according to recent guideline classifications and management.  In addition, while prior studies were based on retrospective data using older guidelines and did not include the potential influence of catheter ablation, this five-year prospective study is also the first to include catheter ablation as an alternative to conventional antiarrhythmic drug therapy.

Atrial fibrillation is a very common and serious heart rhythm disorder that can lead to other heart rhythm problems, chronic fatigue and congestive heart failure. The chance of having a stroke is five times higher for those with AF. The long-term, prospective follow-up study, led by Carlo Pappone, MD, provides new insights on the progression of AF and shows that over a five-year follow-up, patients with lone AF, defined as AF occurring in the absence of structural heart disease, are at a very low risk to progress from the first detected episode to permanent AF.  However, patients with AF and comorbidities, the presence of two or more disease processes, require treatment to avoid AF recurrences and arrhythmia progression.

Among 402 screened patients with a first episode of AF, 106 patients were selected and followed for five years. Of the 106 patients selected, 50 percent had lone AF and 49 percent had comorbidities.  Results at the end of the five-year follow-up included:

• 54 patients, 61 percent of those with lone AF, had no further recurrence after five years. 
• 45 patients received antiarrhythmic drug therapy; 24 of whom developed persistent AF and then 16 of whom went on to develop permanent AF.
• 11 patients underwent catheter ablation resulting in no AF recurrences or AF progression.

“Many prior studies reported predictors of AF development, but did not report predictors of arrhythmia progression; through this study, we found age, diabetes and heart failure to predict final progression,” stated author Carlo Pappone, MD, Department of Cardiology, San Raffaele University Hospital, Milan, Italy. “By identifying key arrhythmia progression predictors, patients at risk of AF progression will be better managed from an early ablation stage.”

Unlike previous research, the study also shows that catheter ablation significantly reduces AF recurrences, delaying arrhythmia progression in almost all patients as compared to antiarrhythmic drug therapy.  This has an important clinical impact in the growing AF population, considering the difficulty to maintain long-term sinus rhythm with antiarrhythmic drugs and the association of poor safety implications.

For more information about this study, please visit www.heartrhythmjournal.com 

About HeartRhythm Journal
HeartRhythm, the official journal of the Heart Rhythm Society provides rapid publication of the most important science developments in the field of arrhythmias and cardiovascular electrophysiology (EP). As the official journal of the Heart Rhythm Society, HeartRhythm publishes both basic and clinical subject matter of scientific excellence devoted to the EP of the heart and blood vessels, as well as therapy. The journal is the only EP publication serving the entire electrophysiology community from basic to clinical academic researchers, private practitioners, technicians, industry and trainees. HeartRhythm has a new impact factor of 4.203 for 2007 and ranks 10th out of 72 cardiovascular medicine journals by the Institute for Scientific Information. Additionally, the journal ranks seventh in the Immediacy Index among cardiology publications. It is also the official publication of the Cardiac Electrophysiology Society.