May 21, 2008 - Antiarrhythmic drug treatment during the six weeks following atrial fibrillation (AF) ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and the need for cardioversion or hospitalization, according to new research released at Heart Rhythm 2008, the Heart Rhythm Society’s 29th Annual Scientific Sessions.
The 5A Study, conducted by researchers at the Hospital of the University of Pennsylvania, prospectively randomized patients with paroxysmal AF who had undergone ablation to receive antiarrhythmic drugs (AAD group) or to not receive empiric antiarrhythmic treatment (no AAD group).
“It is common for atrial arrhythmias to follow atrial fibrillation ablation early on and antiarrhythmic drugs are often prescribed during this period to reduce arrhythmia episodes, however, the benefit of this approach is unclear,” stated Jean-Francois Roux, M.D., lead author and electrophysiology fellow at the Hospital of the University of Pennsylvania in Philadelphia, PA. “Our study was designed to look at the differences in outcome between using empiric AAD treatment versus not using AAD treatment in patients with AF who had undergone ablation to determine if there are in fact benefits.”
In the AAD group, the agent was given to patients beginning the night of the procedure. In the no AAD group, only AV nodal blocking agents were prescribed. All patients wore a monitor with daily and symptomatic transmissions for four weeks after discharge and were evaluated at six weeks. Of the 110 patients enrolled, 53 were randomized to AAD and 57 to no AAD.
During the six weeks following ablation, 40 percent of patients in the no AAD group met the primary endpoint (composite of atrial arrhythmias lasting more than 24 hours, requiring hospitalization or cardioversion, or intolerance to AAD), compared to 14 percent in the AAD group. Three adverse events requiring drug termination included rash, headaches and severe fatigue.
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