Antiarrhythmic Therapy Post-Ablation to Reduce Atrial Fibrillation Recurrence: a Meta-Analysis
2Department of Cardiology, Medical University of Warsaw
3Casa di Cura San Michele, Laboratorio di Elettrofisiologia
4Women's College Research Institute and Cardiovascular Division, Department of Medicine, Institute for Clinical Evaluative Sciences, University of Toronto
5Women's College Research Institute and Cardiovascular Division, Department of Medicine, Sunnybrook Hospital, University of Toronto
Introduction: 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
Objective: 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: Seven prospective trials were included. Among 919 patients 615 (67 %) had paroxysmal AF, and 304 (33%) had persistent AF. In total, 489 patients were treated with AADs and 422 patients served as a control group (no AAD therapy). Various class IC-III antiarrhythmics were used. Length of AAD administration varied between 6 immediately following AFA to 12 weeks. The follow-up duration ranged from 1.5 to 17 months. Among AAD treated patients, the recurrence of arrhythmia rate was 31.5 % vs 38 % in control patients (odd ratio 0.79, 95% CI 0.58-1.09, P=0.15). Also comparing patients who received Amiodarone, no difference in recurrence of atrial arrhythmia were observed (odds ratio 0.60, 95% CI 0.34-1.09, P=0.09).
Conclusions: antiarrhythmic therapy in early post-ablation after AFA period does not reduce rates of the later arrhythmia recurrence
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