New publications
Study shows 'superior' results for atrial fibrillation treatment
Last reviewed: 02.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Atrial fibrillation (AF) is the most common form of arrhythmia, or irregular heartbeat, in the world, affecting millions of people. In a study published in the journal Heart Rhythm, researchers at Brigham and Women's Hospital, part of the Mass General Brigham Health System, analyzed real-world clinical data to evaluate the impact of advanced treatments on patient outcomes after the most common procedure for AF: radiofrequency (RF) ablation.
One year after the procedure, 81.6% of patients were free of atrial arrhythmias, higher than rates reported in clinical trials, and 89.7% of those patients were free of antiarrhythmic drugs. The results were presented simultaneously at the Heart Rhythm 2024 meeting in Boston, Massachusetts.
"When we implement better strategies for radiofrequency ablation, we can significantly improve long-term patient outcomes," said lead study author Dr. Paul Zei, an electrophysiologist and researcher at Brigham and Women's Hospital.
"When using highly trained operators using advanced techniques, we report excellent short-term and long-term clinical outcomes, with over 80% long-term success and very low complication rates."
RF ablation uses radiofrequency energy to inactivate the cardiac tissue responsible for creating irregular electrical signals. Although RF ablation has previously been shown to be safe and effective in randomized, controlled clinical trials, the technique is constantly evolving, and little is known about its effectiveness and safety outside of clinical trials.
The study used data from the REAL-AF registry, a multicenter registry that Zei co-founded in 2019 to evaluate long-term outcomes and clinical management in patients treated for AF. The registry includes more than 50 centers that routinely perform large numbers of RF ablation procedures and adhere to current best practices, including a focus on pulmonary vein isolation, reducing or eliminating the use of fluoroscopy during the procedure, and using a shorter but more intense RF pulse to reduce procedure time.
"We studied experienced operators and centers to make sure we were exploring the best techniques that were already being used," Zei said. "Our motivation is to figure out the best approaches to RF ablation and to adjust and improve those approaches so that our results get even better."
The researchers evaluated data from 2,470 patients in the REAL-AF registry who underwent RF ablation for paroxysmal AF, a form of AF in which symptoms come and go. For each patient, the team assessed the timing and technique of the procedure, and looked at patient outcomes immediately after the procedure and 12 months later.
Zei’s team reports that the procedures in the REAL-AF registry are more effective, safe, and efficient than data from randomized clinical trials. One year after the procedure, 81.6% of patients were free of atrial arrhythmia, and 85.7% of patients were free of AF. In addition, 93.2% of patients reported no arrhythmia symptoms during the follow-up period.
Average procedure times were also significantly shorter, improving patient safety by reducing time under anesthesia and allowing hospitals and operators to perform more of these high-demand procedures.
Going forward, the researchers plan to continue refining the RF ablation procedure for both paroxysmal AF, which is the focus of this study, and persistent AF.
"This is an ongoing effort," Zei said. "An important next step will be to apply similar strategies to understand how to improve this procedure for patients with persistent AF, which is more difficult to treat than paroxysmal AF."
Going forward, Zei says the registry model used in this study could easily be adapted to optimize other medical procedures in electrophysiology and beyond.
"In addition to being a study, the registry is a health care learning network. We're not only evaluating the best approach to RF ablation; we're also learning from each other," Zei said. "The goal is to disseminate best practices among all operators and centers."