Posted by Mike Ware on December 05, 2002 at 23:08:10:
In Reply to: Re: New England Journal on Afib treatment posted by Kati on December 05, 2002 at 21:53:04:
Kati, the AFFIRM study group consisted of people with afib who were 65 years old or older, and people with afib under 65 if they had one other clinical risk factor for stroke. The results may or may not apply to other age or risk groups.
The major revelation of the AFFIRM study was that achieving normal sinus rhythm (NSR) using anti-arrhythmia drugs neither improved quality of life nor did it reduce stroke risk compared to afibbers on a rate control drug. The study results may have been skewed by the fact that patients on anti-arrhythmia drugs could stop taking coumadin if they were in NSR. 70% of the people in the study on anti-arrhythmia drugs were taking coumadin compared to 85-90% of the people on rate control drugs.
Based on the AFFIRM study, doctors may adopt rate control drugs as their primary treatment for afib instead of anti-arrhythmia drugs. For afibbers with debilitating symptoms, particularly at younger ages, I don't think the AFFIRM study results would support insurance companies disallowing the use of maze or ablation procedures to obtain a cure to afib.
A long-term study is needed to compare maze to ablation outcomes over time, and to also compare maze and ablations with rate control outcomes over time with respect to stroke, quality of life, etc.
- Re: New England Journal on Afib treatment steve giddings 15:55:52 12/06/2002 (0)