Results
arrhythmia
ARRHYTHMIA
From April 2015 to August 2017, 835 patients were approached; 182 failed screening, 332 were not eligible (Screening, randomization, treatment, and follow-up. Consort diagram showing the patient numbers at each stage of the study. Patients referred to an arrhythmia specialist with a diagnosis of paroxysmal atrial fibrillation (AF) were screened. Enrolment was offered to those considered clinically suitable for any of the three treatment arms. Randomization took place once the treatment schedule was confirmed to be feasible irrespective of the assigned arm.Baseline characteristicsAVATAR, Ablation Versus Anti-arrhythmic Therapy for Reducing All Hospital Episodes from Recurrent.In the AVATAR arm, 108 of 110 patients (98%) underwent the planned ablation. Of these, 92 (84% of patients randomized) were discharged the same day. Seventeen patients (16%) were referred for a redo procedure at the 8-week review of whom 13 (12%) completed the procedure. Ninety-four patients (85%) achieved symptom control and were discharged from specialist hospital care following review at 12 weeks. Protocol deviations and peri-procedural characteristics are shown in In the anti-arrhythmic arm, 96 patients (93%) attended the initial review. The 4-week review was attended by 89 patients (86%) and the 8-week review by 91 patients (88%). At each review, anti-arrhythmic treatment was optimized, and 93 patients (90%) had a change in medication. At 12 weeks, 47 patients (46%) had achieved symptom control and were discharged from specialist hospital care, and 2 patients had crossed over and completed ablation.In the conventional ablation arm, 103 of 108 underwent the planned ablation (95%). Ninety-nine patients had confirmed PVI (92%). Ten patients (10%) were referred for a redo procedure at 8-week review, of whom 7 (7%) completed the redo procedure. Ninety-seven patients (90%) were discharged from specialist hospital care following review at 12 weeks.Of those who attended the 12-week review, 78 patients (76%) in the drug therapy arm were taking a Class I/Class III anti-arrhythmic agent compared to 11 (11%) in the AVATAR arm and 12 (12%) in the conventional ablation arm (Drug changes during 12week treatment pathwayAVATAR, Ablation Versus Anti-arrhythmic Therapy for Reducing All Hospital Episodes from Recurrent.Drugs taken as pill-in-the-pocket are not included as regular medications.