Andrade JG, Wells GA, Deyell MW, et al. - Among patients with atrial fibrillation, a trial of one or more antiarrhythmic drugs before considering catheter ablation is advised by guidelines, but a greater effectiveness in maintaining sinus rhythm may be conferred by first-line ablation, so, to explore this topic, researchers randomized 303 patients with symptomatic, paroxysmal, untreated atrial fibrillation to receive catheter ablation with a cryothermy balloon or to receive antiarrhythmic drug therapy for initial rhythm control in this study. To identify atrial tachyarrhythmia, all the patients received an implantable cardiac monitoring device. The first reported recurrence of any atrial tachyarrhythmia between 91 and 365 days post-catheter ablation or the start of an antiarrhythmic drug was the primary endpoint. Findings demonstrated that a significantly lower rate of atrial fibrillation recurrence was provided by catheter cryoballoon ablation vs antiarrhythmic drug therapy, as evaluated by continuous cardiac rhythm monitoring, in patients undergoing initial treatment for symptomatic, paroxysmal atrial fibrillation.