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Author of the article: Montreal Heart Institute GNW

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MONTREAL, Nov. 07, 2022 (GLOBE NEWSWIRE) — Physician researchers from the Montreal Heart Institute (MHI) presented new data today at the American Heart Association Late-Breaking Sessions. Published simultaneously in the New England Journal of Medicine, the data show that catheter ablation may be better than antiarrhythmic drugs in stopping the progression of the disease.

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Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting approximately 1 to 2% of the total population. Treatment guidelines recommend a trial of drug therapy to maintain a normal atrial heart rate before considering catheter ablation. However, these drugs have only a limited ability to maintain a normal heart rhythm and have significant side effects. Catheter ablation is considered superior to antiarrhythmic drugs in maintaining normal (sinus) rhythm and improving quality of life in patients in whom drugs have already failed, but it was previously unknown whether earlier ablation could prevent disease progression .

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“By treating patients with catheter ablation from the beginning, we see fewer people progressing to more persistent, life-threatening forms of AF,” said MHI-collaborating electrophysiologist Dr. Jason Andrade, assistant professor of medicine at the University of Montreal. and lead author of the EARLY-AF study.

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“These data provide clear evidence that an early interventional treatment may be a more effective method to improve the lives of our patients with atrial fibrillation. Furthermore, this study further supports the recommendation of continued catheter ablation as an initial treatment strategy in appropriate patients.” added Dr. Laurent Macle, head of the electrophysiology service at MHI and co-chair of the Canadian Cardiovascular Society guidelines on atrial fibrillation. The findings, published today in New England Journal of Medicineare from a multisite clinical trial known as Early Aggressive Intervention for Atrial Fibrillation (EARLY-AF). For the EARLY-AF trial, the pan-Canadian research team enrolled 303 AF patients at 18 sites across Canada. Half of the patients were randomized to receive antiarrhythmic drugs, while the other half were treated with first-line catheter ablation using cryoablation. All patients received an implantable monitoring device that recorded their heart activity over a three-year period.

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At the end of the three-year study, the researchers found that patients in the cryoablation group were 75% less likely to develop persistent AF compared with patients treated with antiarrhythmic drugs. Catheter ablation over follow-up was associated with a 69% reduction in hospitalization and fewer serious adverse health events. In previous work, the same group showed that first-line catheter ablation was more effective than antiarrhythmic drugs in reducing the short-term recurrence of atrial fibrillation. The current study demonstrates that the intervention prevents disease progression. While the condition begins as a single electrical disturbance, each repeated occurrence can cause electrical and structural changes in the heart that can lead to long-term events known as persistent AF. These long-term events have been associated with an increased risk of serious health conditions, including stroke and heart failure, as well as higher rates of hospitalization.

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“Atrial fibrillation is like a snowball rolling down a hill. With each episode of atrial fibrillation there are gradual changes in the heart that make the heart rhythm problem worse and worse,” explains Dr. Andrade. “Effective early intervention can help prevent this disease progression, which can be life-changing for our patients.” Researchers say more effective early interventions would benefit patients as well as the health care system. Currently, costs associated with atrial fibrillation care are estimated at two and a half percent of total annual health care costs, and these costs are expected to increase to 4 percent within the next two decades.

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“Evidence is increasingly showing that it is time to rethink how we approach the treatment of atrial fibrillation. With effective early intervention, we can keep people healthy, happy and out of hospital, which would be a huge benefit to patients and their families, and to our entire health system.” About the Montreal Heart Institute Founded in 1954, the Montreal Heart Institute continually strives for the highest standards of excellence in the cardiovascular field through its leadership in clinical and basic research, highly specialized care, professional training and prevention. It houses the largest research center in Canada, the largest cardiovascular prevention center in the country and the largest cardiovascular genetics center in Canada. The Institute is affiliated with the Université de Montréal and has more than 2000 employees, including 245 doctors and more than 85 researchers. Attached

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