Premium
Antiarrhythmic Drug Therapy after Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation
Author(s) -
TURCO PIETRO,
DE SIMONE ANTONIO,
LA ROCCA VINCENZO,
IULIANO ASSUNTA,
CAPUANO VINCENZO,
ASTARITA COSTANTINO,
DI NAPOLI TOMMASO,
MESSINA VINCENZO,
BALDI SILVANO,
STABILE GIUSEPPE
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00618.x
Subject(s) - medicine , atrial fibrillation , ablation , asymptomatic , amiodarone , cardiology , catheter ablation , ambulatory , refractory (planetary science) , pulmonary vein , surgery , anesthesia , physics , astrobiology
Objectives: The use of antiarrhythmic drugs after ablation is a controversial issue when evaluating the efficacy of atrial fibrillation (AF) ablation. This study compares in a prospective and randomized fashion the impact of an antiarrhythmic drug in preventing AF recurrence after AF ablation.Methods: From February 2004 to May 2005, 107 consecutive patients (mean age 57 ± 10 years, 69 men), with paroxysmal (60%) or persistent (40%) drug refractory AF, were randomly assigned to ablation alone (Group A, 53 patients) or combined with the best antiarrhythmic therapy, preferably amiodarone (Group B, 54 patients). All patients underwent cavo‐tricuspid and left inferior pulmonary vein (PV)‐mitral isthmus ablation plus circumferential PV ablation, using a guided electro‐anatomical approach. Standard electrocardiograms (ECG), and ambulatory and transtelephonic ECG monitoring were used to assess AF recurrences. Recurrences during the first month after ablation were excluded from this analysis.Results: At 12 months of follow‐up, no significant difference was observed in the rates of AF recurrences between Group A (18/53 patients, 34%) and Group B (16/54 patients, 30%). The percentage of patients with ≥1 asymptomatic AF episode was higher in Group B than in Group A (10/16 patients, 63%, vs 5/18 patients, 28%, P = 0.04).Conclusions: Continuing antiarrhythmic drug therapy in patients who undergo catheter ablation for AF did not lower the rate of AF recurrences. Antiarrhythmic drugs increased the proportion of patients with asymptomatic AF episodes.