HOW SHOULD NEW TECHNOLOGIES BE ASSESSED?
The huge growth in AF ablation, and the complexity of the procedure has led to great interest in the development of new technologies to try and make the procedure quicker, safer and more effective. Whether one technology or technique is superior to another can only be proven in randomised controlled trials. This is a clinical trial where patients suitable for treatment are randomly allocated to receive one of two treatments being tested. The reason that patients must be randomly allocated is to prevent bias (both conscious and subconscious) on the part of the researcher. For example, if a researcher has been involved in developing a new technique they may have a tendency to allocate patients more likely to have a good outcome in that treatment and the more difficult patients in the rival treatment. Randomisation avoids this bias.
BUT HOW ARE NEW TECHNOLOGIES ASSESSED?
It may surprise you to know that while new technologies have to undergo rigorous safety testing before being approved for use they do not have to be shown to be superior to existing treatments. Therefore many new technologies have not even been shown to be superior to placebo or medication in randomised trials. The claims made for technologies are often based on uncontrolled series of patients or even theories developed from observation in animal experiments. Therefore when deciding on how you wish your AF ablation to be performed it is important to know not what technology the doctor uses but what their personal results are and how many they have done. If your doctor is not collecting their follow up results in a rigorous manner they don’t really know what their results are, and therefore whether the technology they use actually works. If your doctor does know what their results are then you should be guided by them as to what technique they feel works best for them.