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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

When should we discontinue antiarrhythmic therapy for atrial fibrillation after coronary artery bypass grafting? A

Uzi Izhar1, Niv Ad, Ehud Rudis

  • 1Department of Cardiothoracic Surgery, Hadassah University Hospital, Jerusalem, Israel. izharu@bezeqint.net <izharu@bezeqint.net>

The Journal of Thoracic and Cardiovascular Surgery
|January 29, 2005
PubMed

Insights

Short-term antiarrhythmic therapy, even just one week, may be sufficient for patients experiencing new-onset atrial fibrillation after coronary artery bypass grafting. This approach appears safe and effective in preventing recurrence.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pharmacology

Background:

  • New-onset atrial fibrillation is a frequent complication following coronary artery bypass grafting (CABG).
  • Current medical management involves antiarrhythmic drugs for heart rate control and rhythm restoration.
  • The optimal duration of post-discharge antiarrhythmic therapy remains an important clinical question.

Purpose of the Study:

  • To evaluate the appropriate duration of antiarrhythmic therapy after hospital discharge in patients with new-onset atrial fibrillation post-CABG.
  • To determine if shorter durations of therapy are as effective as longer durations in preventing recurrent atrial fibrillation.

Main Methods:

  • A prospective randomized study involving 129 patients with new-onset atrial fibrillation post-CABG who reverted to sinus rhythm before discharge.
  • Patients were randomized to receive antiarrhythmic therapy for 1 week, 3 weeks, or 6 weeks.
  • Follow-up included monitoring for recurrent atrial fibrillation for an additional 4 weeks post-therapy.

Main Results:

  • No significant difference in the recurrence of atrial fibrillation was observed among the three treatment groups (0%, 2%, and 0%).
  • Various antiarrhythmic medications were used for conversion, with amiodarone being most common.
  • High follow-up completion rate (99.2%) ensures reliability of results.

Conclusions:

  • New-onset atrial fibrillation after CABG, when converted to sinus rhythm before discharge, generally follows a benign clinical course.
  • A 1-week duration of antiarrhythmic therapy may be adequate for these patients, simplifying treatment regimens.
  • This finding supports a de-escalation of post-operative antiarrhythmic drug use in selected patients.
Abstract

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