Date of Award
2026
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Introduction- Atrial fibrillation is a common type of cardiac arrythmia that affects many people across the world. Patients with atrial fibrillation are at high risk for complications and poor outcomes. Stroke is the most prominent complication of atrial fibrillation if left untreated. The purpose of this clinical review is to analyze which modality is a better first line treatment, antiarrhythmic drug therapy or catheter ablation for long term management of this arrythmia.
Methods- Pubmed was searched with a specific search strategy using key terms “cardiac”, “Arrythmia”, “Antiarrhythmic agents”, “radiofrequency ablation”, and “surgical operation”. Operators and filters such as ((atrial fibrillation) OR (afib) OR (AF)) AND ((rhythm control) OR (antiarrhythmic)) AND ((ablation) OR (Radiofrequency ablation) OR (Cryoablation) OR (Pulsed Field Ablation) OR (Laser Ablation) OR (Catheter Ablation)) AND (Recurrence) narrowed results to 81 articles. These articles were further investigated for direct correlation to the intended question and four quality articles were selected to be included in this review.
Results- The four articles compared antiarrhythmic drugs to catheter ablation techniques for the treatment of atrial fibrillation. The studies collected data to track effectiveness of ablation therapy versus antiarrhythmic drug therapy in reducing the recurrence of atrial fibrillation. Data was gathered in most studies over a span of six months to two years. Results supported the use of catheter ablation over drug therapy for first line treatment. This was a consistent finding in all studies with each using 95% confidence intervals and statistically significant P values (P< .001).
Discussion: The articles reviewed lean strongly in favor of ablation therapy for the initial management of atrial fibrillation. Less reoccurrences of atrial tachycardias were reported when utilizing ablation therapy. Antiarrhythmic drug therapy continues to be the initial treatment of choice due its convenience despite current research. Data from the articles included in this review show low risks of adverse events with ablation procedures. Further research and diverse sample groups is necessary for ablation therapy to move towards initial treatment of choice. Benefit of this procedure must be backed by significant data over longer periods of time. This will alleviate potential weaknesses of the study and show how ablation therapy is most effective for patient outcomes and efficient for our healthcare system.
Recommended Citation
Hargrove J. Pharmacologic Therapy versus Catheter Ablation for Atrial Fibrillation. The PA Department Journal of Medical Science. 2026. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/35
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