Short-term Antiarrhythmic Drugs After Catheter Ablation for Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials
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Updated: Mar 19, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Buyun Xu1, Fang Peng1, Weiliang Tang1
1Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.
Insights
Short-term antiarrhythmic drugs (AADs) after catheter ablation (CA) for atrial fibrillation (AF) reduce early recurrence but do not prevent late recurrence. This finding impacts post-ablation arrhythmia management strategies.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- Catheter ablation (CA) for atrial fibrillation (AF) has limitations due to recurrent arrhythmias.
- Short-term antiarrhythmic drug (AAD) use post-CA is a strategy to mitigate recurrence.
Purpose of the Study:
- To evaluate the efficacy of short-term AADs following CA for AF in preventing atrial tachyarrhythmia recurrence.
- To differentiate effects on early versus late recurrence.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched PubMed, Embase, Cochrane Library, and ClinicalTrials.gov up to May 2016.
- Included 6 RCTs with 2764 patients, analyzing early and late recurrence rates.
Main Results:
- Short-term AADs significantly reduced early recurrence of atrial tachyarrhythmias (RR 0.78, 95% CI 0.62-0.98).
- No significant difference was observed in late recurrence of AF (LRAF) between AAD and control groups (RR 0.94, 95% CI 0.85-1.05).
Conclusions:
- Short-term AADs are effective in reducing early post-CA atrial tachyarrhythmias.
- AADs do not prevent late recurrence of AF after catheter ablation.
Background:
The incidence of recurrent arrhythmia after catheter ablation (CA) for atrial fibrillation (AF) is unacceptable. Short-term antiarrhythmic drug (AAD) treatment following CA was presumed to be effective in reducing recurrent arrhythmia.
Objective:
To fully evaluate the efficacy of short-term use of AADs following CA for AF in preventing recurrence of atrial tachyarrhythmias.
Methods:
PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched up until May 1, 2016. We enrolled randomized controlled trials (RCTs) that evaluated the efficacy of short-term use of AADs following CA for AF in preventing early and/or late recurrence of atrial tachyarrhythmias. The statistical analyses were performed using Review Manager Version 5.3.
Results:
Six RCTs were included in this analysis, involving a total of 2764 patients. The frequency of early recurrence of atrial tachyarrhythmias was 39.5% in the AAD group (556 of 1407) and 47.2% (640 of 1357) in the control group. The pooled risk ratio of the AAD group to the control group was 0.78 (95% CI = 0.62-0.98). Regarding late recurrence of AF (LRAF), the incidence in the AAD group and the control group was 32.5% (420 of 1293) and 34.6% (450 of 1300), respectively. No significant difference was identified between the 2 groups (relative risk = 0.94, 95% CI = 0.85-1.05).
Conclusions:
Short-term use of AADs following CA for AF reduced the incidence of early recurrent atrial tachyarrhythmias but did not prevent LRAF.
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