Why the study?
Data are limited on changes in atrial fibrillation burden following the initiation of antiarrhythmic drugs.
Does antiarrhythmic drug initiation reduce atrial fibrillation burden in patients with cardiac implantable electronic devices?
Does antiarrhythmic drug initiation reduce atrial fibrillation burden in patients with cardiac implantable electronic devices?
Initiation of antiarrhythmic drugs in patients with CIEDs is associated with a significant reduction in device-detected atrial fibrillation burden.
Answers are grounded in this paper and cite their sources.
AAD initiation was associated with large AF burden reductions in CIED patients; leaves open need for RCTs on outcomes and practice change.
Background: There are limited data on changes in atrial fibrillation (AF) burden after antiarrhythmic drug (AAD) initiation. Objective: The purpose of this study was to quantify AF burden after AAD initiation in patients with cardiac implantable electronic devices (CIEDs). Methods: We conducted a retrospective study of all patients with CIEDs from 2 academic hospitals with new AAD initiation between April 2018 and March 2022. AF burden was quantified in patients with CIEDs at up to 6 months pre- and 12 months post-AAD initiation. In patients with AF >30 seconds after AAD initiation, the median reduction in AF burden was 72.1% (IQR 5.3%-96.9%) at the final interrogation. Conclusion: There was a median reduction in AF burden of 97.4% (IQR 35.7%-100%) after AAD initiation in patients with CIEDs at the final interrogation. Results are consistent in subgroups of AAD type and baseline AF burden.
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Schwartz et al. (2026) studied this question.
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