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Updated: Mar 31, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Multicenter analysis of device-detected atrial fibrillation burden reduction after antiarrhythmic drug initiation

Sarah M Schwartz1, Graham Peigh2, Kasen Culler2

  • 1Division of Cardiology, Department of Medicine, New York-Presbyterian Hospital, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.

Heart Rhythm O2
|March 30, 2026
PubMed

Insights

Antiarrhythmic drug initiation significantly reduced atrial fibrillation burden in patients with cardiac implantable electronic devices. This reduction was substantial and consistent across various patient subgroups and drug types.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Limited data exist on atrial fibrillation (AF) burden changes post-antiarrhythmic drug (AAD) initiation.
  • Understanding these changes is crucial for managing patients with AF, particularly those with cardiac implantable electronic devices (CIEDs).

Purpose of the Study:

  • To quantify the change in AF burden after initiating AADs in patients with CIEDs.
  • To assess the effectiveness of AADs in reducing AF burden in this specific patient population.

Main Methods:

  • Retrospective study of 128 patients with CIEDs who initiated new AADs between April 2018 and March 2022.
  • AF burden was measured up to 6 months pre- and 12 months post-AAD initiation using CIED data.
  • Analysis included comparisons of AF burden at baseline, first post-initiation, and final interrogations.

Main Results:

  • A significant reduction in AF burden was observed post-AAD initiation.
  • Median AF burden decreased from 5.9% pre-AAD to 0.2% at the first interrogation and 0.1% at the final interrogation.
  • Reductions were consistent across amiodarone and non-amiodarone AAD subgroups, and in patients with high and low baseline AF burden.

Conclusions:

  • AAD initiation leads to a substantial median reduction in AF burden (97.4%) in patients with CIEDs by the final interrogation.
  • The effectiveness of AADs in reducing AF burden is consistent regardless of AAD type or baseline AF burden.
Abstract

Keywords:
AmiodaroneAntiarrhythmic drugAtrial fibrillationAtrial fibrillation burdenCardiac implantable electronic devices

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