A Randomized Clinical Trial of the Efficacy of Radiofre
quency Catheter Ablation and Amiodarone in the Treat
ment of Symptomatic Atrial Fibrillation
RUNGROJ KRITTAY APHONG, MD*, ONGKARN RAUNGRATTANAAMPORN, MD***,
KIERTUAI BHURIPANYO, MD***, CHARN SRIRA TANASATHA VORN, MD**,
SUKANY A POORANA WATTANAKUL, BSc**, KESAREE PUNLEE, BSc**,
CHARUWAN KANGKAGATE, MS**
Affiliation : * Division of Cardiology, Department of Medicine,
**Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700,
*** Bangkok Heart Institute, Bangkok Hospital, Bangkok 10320, Thailand.
AbstractThe limited efficacy and proarrhythmic risks of antiarrhythmia agents have resulted in alter
native therapeutic approaches. Radiofrequency ablation has been reported to be an effective treatment
of patients with atrial fibrillation. However, there is no randomized clinical trial comparing drug and
radiofrequency ablation. The authors randomized 30 patients with chronic atrial fibrillation refractory
to medication into amiodarone and radiofrequency ablation. The primary objective of this study was to
compare the efficacy of amiodarone and radiofrequency ablation in the maintenance of sinus rhythm
at I year after randomization. Pulmonary vein isolation and linear ablation of right atrium was the
technique used for radiofrequency ablation. There were no significant differences in baseline patient
characteristics between the 2 groups. The results of this study showed that the probability of free from
atrial fibrillation was better in the radiofrequency ablation group compared to amiodarone (78.6% in
=
the ablation group and 40% in the amiodarone group, p 0.018). Radiofrequency ablation results in a
significant reduction in symptoms relating to atrial fibrillation and a significant improvement in quality
of life, whereas amiodarone had no significant effect on symptoms and quality of life. There was an
ischemic stroke as a major complication related to radiofrequency ablation. Amiodarone was asso
ciated with adverse effects in 46.7 per cent of patients and needed discontinuation in 1 patient. In con
clusion, radiofrequency ablation is an effective alternative treatment in patients with atrial fibrillation
refractory to medication.
Keywords : Atrial Fibrillation, Amiodarone, Radiofrequency Ablation
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