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The Agency for Healthcare Research and Quality (AHRQ) commissioned this report to review the evidence for the clinical effects and safety of radiofrequency catheter ablation (RFA) for the management of atrial fibrillation (AF). Over the past decade, RFA has rapidly evolved as a tool for managing AF in select patients. This rapid evolution has been driven by an enhanced understanding of the triggers and etiology of AF and the development of advanced catheter and imaging technologies.
After extensive discussion with AHRQ and the technical expert panel (TEP), the key questions to be addressed in this report are: 1) What is the effect of RFA on short- (6 to 12 months) and long- (>12 months) term rhythm control, rates of congestive heart failure, left atrial and ventricular size changes, rates of stroke, quality of life, avoiding anticoagulation, and readmissions for persistent, paroxysmal and long-standing persistent (chronic) atrial fibrillation? 2) What are the patient-level and intervention-level characteristics associated with RFA effect on short- and long-term rhythm control? 3) How does the effect of RFA on short- and long-term rhythm control differ among the various techniques or approaches used? 4) What are the short- and long-term complications and harms associated with RFA?