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Extensive antiarrhythmic drugs after catheter ablation of persistent atrial fibrillation

Jun Gu1, Xu Liu, Hongwei Tan

  • 1Dept. of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.

Acta Cardiologica
|September 25, 2012
PubMed

Insights

Extensive antiarrhythmic drugs (AADs) after atrial fibrillation (AF) ablation reduce early recurrence but do not prevent late arrhythmia. Left atrial diameter and early recurrence predict long-term outcomes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Persistent atrial fibrillation (AF) management post-catheter ablation remains a challenge.
  • The role of early, intensive antiarrhythmic drug (AAD) therapy in preventing recurrence is not well-defined.

Purpose of the Study:

  • To investigate whether early rhythm suppression with extensive antiarrhythmic drugs (AADs) following catheter ablation for persistent atrial fibrillation (AF) reduces arrhythmia recurrence at 12 months.
  • To identify predictors of arrhythmia recurrence after AF ablation.

Main Methods:

  • A prospective, randomized study involving 123 patients with persistent AF undergoing catheter ablation.
  • Patients were assigned to receive either extensive AADs (class Ic and III) or single AAD therapy for the initial 2 months post-ablation.
  • Arrhythmia recurrence was assessed at 2 and 12 months.

Main Results:

  • Early recurrence of atrial tachyarrhythmias (ATa) was significantly lower in the extensive AADs group within the first 2 months (17/62 vs. 29/61, P=0.021).
  • No significant difference in ATa recurrence at 12 months was observed between the groups (21/62 vs. 22/61, P=0.799).
  • Early ATa (at 2 months) and larger left atrial diameter (LAD) were significant predictors of 12-month ATa recurrence.

Conclusions:

  • Intensive AAD therapy in the early period after persistent AF ablation effectively reduces early but not late arrhythmia recurrence.
  • Left atrial diameter and early arrhythmia recurrence are strong predictors of long-term outcomes following AF ablation.
Abstract

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