Open AccessPrognostic value of pharmacotherapy in patients with atrial fibrillation after radiofrequency ablation
Author(s) -
М. С. Брынза,
Oleksandr Bilchenko,
Е. С. Махаринская,
М. И. Шевчук
Publication year - 2021
Publication title -
zaporožskij medicinskij žurnal
Language(s) - English
Resource type - Journals
eISSN - 2310-1210
pISSN - 2306-4145
DOI - 10.14739/2310-1210.2021.6.229973
Subject(s) - medicine , atrial fibrillation , pharmacotherapy , radiofrequency ablation , catheter ablation , clinical endpoint , cardiology , amiodarone , ablation , supraventricular arrhythmia , propafenone , supraventricular tachycardia , surgery , tachycardia , randomized controlled trial
The aim of the work: to evaluate the prognostic effect of pharmacotherapy before and after radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) on all-cause mortality, supraventricular arrhythmia recurrence and non-fatal cardiovascular events.Materials and methods. Patients with paroxysmal, persistent and long-term persistent forms of AF were examined before and after RFA – isolation of pulmonary veins. The primary endpoint was patient survival, secondary – a composite endpoint of freedom from recurrence and/or non-fatal cardiovascular events for 2 years of a follow-up. Frequency and doses of pharmacotherapy were evaluated. Standard statistical procedures were used for initial data evaluation.Results. 116 patients were consecutively enrolled in the study. In the long-term post-ablation, 23 patients (19.8 %) continued to take amiodarone, 2 patients (1.7 %) – propafenone for arrhythmic events, 38 patients (32.8 %) needed anticoagulants, and 37 patients (31.9 %) received beta-adrenoceptor blockers over the entire follow-up period. The use of RAAS inhibitors decreased from 81.0 % before the ablation to 56.0 % in the long-term period following RFA. Multifactorial logistic regression analysis showed that the prolonged (more than 3 months) anticoagulation (P = 0.032) after RFA was an independent predictor of patient survival in the two-year follow-up; doses of anticoagulants before the procedure, use and doses of beta-adrenoceptor blockers in the long-term post-ablation period were associated with the secondary endpoint.Conclusions. RFA for AF significantly reduced the frequency of medications use in the long-term postoperatively. Independent predictors of survival were the doses of anticoagulants more than 3 months after ablation, arrhythmia recurrence and non-fatal cardiovascular events – the doses of anticoagulants before the procedure, and the use and doses of beta-adrenoceptor blockers in the long-term period after RFA.