Key result
Continuing previously ineffective antiarrhythmic drugs post-ablation cuts 1-year atrial tachyarrhythmia recurrence by ~88%.
Why the study?
Does continued use of previously ineffective antiarrhythmic drug therapy reduce the recurrence of atrial tachyarrhythmia in patients with paroxysmal AF who are free of AF 3 months post-pulmonary vein isolation?
Population
153 patients undergoing contact force-guided pulmonary vein isolation for paroxysmal atrial fibrillation…
Comparison
Continued use of previously ineffective… vs Discontinuation of antiarrhythmic drug therapy.
Design
RCT, 1:1 ratio
Follow-up
1 year after PVI
Authors
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Supports continuing previously ineffective antiarrhythmic drugs after ablation; challenges consensus favoring early discontinuation in paroxysmal AF.
RCT (n=153)
1:1
Yes
Does continued use of previously ineffective antiarrhythmic drug therapy reduce the recurrence of atrial tachyarrhythmia in patients with paroxysmal AF who are free of AF 3 months post-pulmonary vein isolation?
Absolute Event Rate: 2.7% vs 21.9%
p-value: p=<0.001
Continuing previously ineffective antiarrhythmic drug therapy significantly reduces the recurrence of atrial tachyarrhythmias, repeat ablations, and unscheduled visits in the first year following pulmonary vein isolation for paroxysmal AF.
Duytschaever et al. (2017) conducted an RCT in Paroxysmal atrial fibrillation resistant to antiarrhythmic drug therapy (n=153). Continued antiarrhythmic drug therapy (ADT ON) vs. Discontinued antiarrhythmic drug therapy (ADT OFF) was evaluated on Any documented atrial tachyarrhythmia lasting >30 s (p=<0.001). Continuing previously ineffective antiarrhythmic drug therapy after a 3-month post-ablation blanking period significantly reduced atrial tachyarrhythmia recurrence at 1 year (2.7% vs 21.9%; P<0.001).
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