Date of Award

2018

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Vanessa Bester

Abstract

The prevalence of atrial fibrillation is 6.5 percent in the adult population in the United States, in an attempt to treat this patient population, there are numerous options and this study attempts to find the optimal treatment plan that has the least Atrial fibrillation(AF) reoccurrence, best quality of life and is the most effective. This is a Systematic Review comparing catheter ablation therapy vs. drug therapy in treating patients with atrial fibrillation. The search engines used in this analysis include PubMed, UpToDate, Google Scholar and Academic Search Premier. A total of 19 articles were analyzed and data was extracted, and conclusions were made. This review came to three conclusions, Anti-arrhythmic drugs (AAD) had no statistical significance over rate control 2,7,19 but specifically amiodarone had poorer side effects and more hospitalizations 3,7,19. Secondly, catheter ablation therapy was more effective than drug therapy, specifically with multiple procedures and concomitant AAD use in reducing AF reoccurrence and improving quality of life 12,13 . Thirdly, catheter ablation therapy was associated with serious adverse effects such as cardiac tamponade and a 4.7 % increased risk for stroke9 . Keeping this in mind, Amiodarone showed to have an increased risk of stroke by 1.8-fold 2,3, and an increased mortality p=0.0082,19 . AAD therapy has limited use because of the toxic side effects, therefore catheter ablation therapy serves as a promising long-term solution. There should be continued improved efforts towards advancing and optimizing the ablation therapy technique. Patients who fit the characteristics of more likely to succeed should be offered ablation therapy as first line treatment, and additional procedures should be offered until complete cessation of AF.

Identifier

SC11.PAS.2018.Ansara.J

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Cardiology Commons

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