Some high-level takeaways from the paper: 

Early initiation of rhythm-control therapy conveys a clear clinical benefit in patients with recently diagnosed atrial fibrillation (AF)

Based on trial results, rhythm-control therapy should be offered to all patients with recently diagnosed AF and cardiovascular risk factors, including those who present without AF-related symptoms, in addition to anticoagulation, rate control, and therapy of concomitant conditions

Early initiation of rhythm-control therapy, before AF-induced atrial damage (atrial cardiopathy or atrial structural remodelling) has irreversibly damaged the atria, could be more effective and safer than the current symptom-based—and therefore delayed—approach to rhythm-control therapy.

All Things Afib is hosted by me, Dr. Armin Kiankhooy. As a board-certified cardiothoracic surgeon, my focus is on advanced treatments for heart and lung failure and minimally-invasive surgical treatments for atrial fibrillation such as the Hybrid Maze procedure. You can find me on staff at Adventist Health Heart and Vascular Institute in St. Helena California.

Discussion points:

What was the purpose and background of this paper?

How realistic is the patient population, compared to your practice?

Figure 1- Meds vs. Ablation, your thoughts?

Is a figure of 20% of patients treated with Amiodarone normal?

What is your opinion on the long-term outcomes in this study?

Afib and cognitive decline/dementia

This study will change how we practice– it’s a game-changer

What protocols do you recommend for your patients that come in earlier and earlier for AFib?

The Mobile Cardiac Telemetry (MCT) monitor vs. others

How smartwatches are raising patient awareness around AFib, and many times are useful tools in cardiac monitoring

Tadros reiterates just how important this study is for all of us

Resources: 

The EAST-AFNET 4 Study

Dr. Thomas Michael Tadros at Brigham and Women's

Dr. Kiankhooy LinkedIn

All Things AFib Website

All Things AFib Twitter

All Things AFib YouTube Channel