Arrhythmias & electrophysiology
Catheter ablation vs antiarrhythmic drug therapy for first-line treatment of atrial fibrillation in United States clinical practice
Main finding · Hospitalization for atrial arrhythmia (AF, atrial flutter, or tachycardia)Result — go to the resultAdjusted hazard ratio 0.52 95% CI 0.40–0.68Authors' conclusion
First-line CA for both paroxysmal and persistent AF is associated with significantly lower risk of hospitalization for atrial arrhythmia consistent with results from randomized clinical trials and current Class I guideline recommendations.
Study context
- Population
- Persons with incident atrial fibrillation (AF) (2015–2022) in the Optum Clinformatics cohort, categorized by first-line rhythm control treatmentno total printed, counts by treatment group
- Participants
- 2,711 vs 22,726
- Exposure
- Catheter ablation (CA) vs antiarrhythmic drug for first-line rhythm control therapy
- CAn = 2,711
- AADn = 22,726reference
- Outcome
- Hospitalization for atrial arrhythmia (AF, atrial flutter, or tachycardia)
- Follow-up
- 1-year (3-month blanking period)
Methodological detailsOptum Clinformatics cohort, inverse probability of treatment weighting, Cox regression, clinical practice
- Optum Clinformatics cohort
- Inverse probability of treatment weighting
- Cox regression
- Clinical practice
Main finding
As reported in the abstract
Adjusted hazard ratio
0.52
95% CI 0.40–0.68
CAvs AAD
adjusted HR 0.52 (95% CI 0.40–0.68)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| AF-related electrical cardioversion52% lower risk with CA | 0.48 (0.34–0.68) | |
| Hospitalization for heart failure74% lower risk with CA | 0.26 (0.13–0.54) | |
| Atrial arrhythmia hospitalization, by AF type (subgroup)CAvs AADParoxysmal AF | 0.52 (0.37–0.73) | |
| Atrial arrhythmia hospitalization, by AF type (subgroup)CAvs AADPersistent AF | 0.55 (0.37–0.81) | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Catheter ablation vs antiarrhythmic drug therapy for first-line treatment of atrial fibrillation in United States clinical practice. Heart Rhythm. Published 14 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →