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.
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. Results: 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.
Schwartz et al. (Thu,) studied this question.