“Cryoballoon ablation as initial therapy was superior to drug therapy for the prevention of atrial arrhythmia recurrence in patients with (early onset) paroxysmal atrial fibrillation. Serious procedure-related adverse events were uncommon.”*
A recent peer reviewed study from The New England Journal of Medicine revealed important results that should impact how people with early onset AFib should weigh their options for treatment.
First, let’s define early onset, also called paroxysmal, atrial fibrillation. AFib classifications are based on the duration of atrial fibrillation over the course of time. Paroxysmal AFib are episodes of AFib that occur occasionally and usually begin and terminate spontaneously. These AFib episodes can last a few seconds, hours or a few days before stopping, when the heart returns to its normal rhythm. If the condition progresses to the point that it’s constant, that person would move into a different AFib classification – namely persistent AFib.
Patients who are new to the condition should take note of the results of this study that compared more aggressive early treatment to more conservative management of AFib. The findings indicate much better outcomes – or less recurrence of AFib – with the more aggressive early treatment using Cryoballoon ablation surgery versus the less invasive management through medications. Key factors that make it easier for paroxysmal AFib to progress to persistent AFib is the cellular memory of AFib and the change of heart muscle to a fibrotic tissue as a result of the arrhythmia. When the disease progresses, AFib patients have more frequent, or chronic episodes of arrhythmia. This increases a patient’s likelihood for stroke.
The study came about primarily because of the observation that many patients with paroxysmal atrial fibrillation do not respond to the use of medications. Meaning their AFib episodes continue despite the use of antiarrhythmic pharmaceuticals. However, the safety and efficacy of cryoballoon ablation as initial first-line therapy had not yet been established. The study verified the safety of using this more invasive treatment early-on since “serious procedure-related adverse events were uncommon.”^
If you or a loved one are suffering from AFib and are ready to take the next step, please contact our clinic right away. As this study reveals, early treatment is critical to alleviating patients of the condition and allowing them to get back to living a normal life.
Visit The Scoop next week when we’ll discuss what to do if someone you love has AFib.
*Wazni OM, Dandamudi G, Sood N, Hoyt R, Tyler J, Durrani S, Niebauer M, Makati K, Halperin B, Gauri A, Morales G, Shao M, Cerkvenik J, Kaplon RE, Nissen SE; STOP AF First Trial Investigators. Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation. N Engl J Med. 2021 Jan 28;384(4):316-324. doi: 10.1056/NEJMoa2029554. Epub 2020 Nov 16. PMID: 33197158.
^ Supported by Medtronic; STOP AF First ClinicalTrials.gov number, NCT03118518
