To the Editor: In their randomized controlled trial, Dr Wilber and colleagues1 concluded that catheter ablation was superior to antiarrhythmic drug therapy (ADT) in patients with paroxysmal atrial fibrillation (AF) refractory to at least 1 antiarrhythmic drug. However, because of the study design it is possible that the effect of ADT might have been underestimated.
Viganego F. Antiarrhythmic Drug Therapy vs Catheter Ablation for Paroxysmal Atrial Fibrillation. JAMA. 2010;303(18):1808-1810. doi:10.1001/jama.2010.536