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Editorial
February 19, 2014

Has the Time Come to Recommend Catheter Ablation of Atrial Fibrillation as First-Line Therapy?

Author Affiliations
  • 1Johns Hopkins Hospital, Baltimore, Maryland
JAMA. 2014;311(7):679-680. doi:10.1001/jama.2014.468

During the past decade, catheter ablation of atrial fibrillation (AF) has evolved from being a novel unproven procedure for treatment of AF to its role today as an important, commonly performed treatment option for patients with symptomatic AF refractory to antiarrhythmic drug therapy. The 2012 Heart Rhythm Society, European Heart Rhythm Association, and European Society of Cardiology (HRS/EHRA/ECAS) expert consensus document1 on catheter ablation of atrial fibrillation provides a “class 1 level of evidence A” recommendation for catheter ablation of AF for patients with paroxysmal atrial fibrillation for whom treatment with at least 1 antiarrhythmic medication failed and a “class 2 level of evidence B” recommendation for patients with paroxysmal AF for whom antiarrhythmic drug therapy has not failed. Similar recommendations are made by the 2012 update of the European Society of Cardiology Atrial Fibrillation Guidelines.2

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