Antiarrhythmic therapy as an adjuvant to promote post pulmonary vein isolation success-a meta-analysis.

Abstract

BACKGROUND:

Three months of empirical antiarrhythmic drug (AAD) therapy after atrial fibrillation ablation (AFA) is a common practice to prevent early arrhythmia recurrence; the data of influence of this practice on longer term ablation outcomes is limited.

PURPOSE:

The aim of this study was to perform a meta-analysis of published controlled trials comparing temporary AAD therapy after AFA with no AAD therapy in patients after AFA. The primary outcome was recurrence of arrhythmia.

RESULTS:

1Eight prospective trials were included. Among 2952 patients, 1991 (67 %) had paroxysmal AF, and 967 (32.7 %) had persistent AF. In total, 1502 patients were treated with AADs and 1450 patients served as a control group (no AAD therapy). Various class IC-III antiarrhythmics were used. Length of AAD administration varied between 6 and 12 weeks after start of AFA. The follow-up duration ranged from 1.5 to 17 months after stopping medication. Among AAD treated patients, the recurrence of arrhythmia rate was 30.69 vs. 33.79 % in control patients (odd ratio 0.86, 95 % CI 0.71-1.06, P = 0.15). In patients who received largely amiodarone, there was a trend for difference in recurrence of atrial arrhythmia (odds ratio 0.60, 95 % CI 0.34-1.09, P = 0.09).

CONCLUSIONS:

Short-term post pulmonary vein isolation (PVI) AAD therapy does not substantially reduce overall recurrence of AF after ablation.

• Authors: Gustavo R Goldenberg, Daniel Burd, Piotr Lodzinski, Giuseppe Stabile, Jacob A Udell, David Newman, Mohammed Shurrab, Eugene Crystal
• Journal: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (J Interv Card Electrophysiol) Vol. 47 Issue 2 Pg. 171-176 (Nov 2016) ISSN: 1572-8595 [Electronic] Netherlands
• PMID: 27357216 (Publication Type: Journal Article, Meta-Analysis, Review)

Chemical References

• Anti-Arrhythmia Agents

Topics

• Aged
• Anti-Arrhythmia Agents (therapeutic use)
• Atrial Fibrillation (epidemiology, therapy)
• Catheter Ablation (statistics & numerical data)
• Chemotherapy, Adjuvant (statistics & numerical data)
• Combined Modality Therapy
• Female
• Humans
• Male
• Postoperative Care (statistics & numerical data)
• Prevalence
• Pulmonary Veins (surgery)
• Recurrence
• Risk Factors
• Treatment Outcome