ARC-HF: Catheter Ablation vs. Rate Control in Patients With Persistent AFib

"Catheter ablation-based rhythm control improves cardiopulmonary exercise performance, quality of life, and neurohormonal status, compared with a medical rate-control strategy," in patients with persistent atrial fibrillation (AFib) and heart failure, according to results from the ARC-HF trial released on Nov. 5 at AHA 2012 in Los Angeles, Ca.

The trial, which randomized 52 patients to either rate control or catheter ablation, found that ablation led to significant improvements in peak VO2 and QoL Scores and BNP levels, compared to rate control. There was also a trend towards improved left ventricular ejection fraction with ablation.

The trial investigators also noted that after 12 months patients randomized for ablation saw improvement of cardiopulmonary "fitness," as well as "progressive amelioration of the heart failure syndrome."

Despite the small trial size, the investigators noted that the presence of sinus rhythm on multiple visits is highly suggestive of a major reduction in arrhythmia burden in patients with prior persistent AFib.

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