Key result
Amiodarone after surgical ablation linked to ~54% greater sinus rhythm maintenance at three months.
Why the study?
Early recurrence of atrial arrhythmias is a significant problem after ablative procedures, and prophylactic antiarrhythmic drug use has become a possible solution.
Does prophylactic amiodarone prevent atrial fibrillation relapse in patients undergoing surgical radiofrequency ablation?
Cohort (n=59)
No
Does prophylactic amiodarone prevent atrial fibrillation relapse in patients undergoing surgical radiofrequency ablation?
Prophylactic amiodarone for three months following surgical radiofrequency ablation for atrial fibrillation significantly increases the rate of stable sinus rhythm at 3 months without increasing adverse events.
Answers are grounded in this paper and cite their sources.
May support short-term use post-ablation; hypothesis-generating and requires RCT confirmation before practice change.
Background : Atrial fibrillation (AF) is the most common heart rhythm disorder. AF ablation based on endovascular or surgical techniques is a standard of care in everyday practice. Early recurrence of atrial arrhythmias is a significant problem after ablative procedures. Prophylactic use of antiarrhythmic drugs has become a possible solution. Materials and methods : We performed a retrospective observational cohort study of 59 patients with heart disease requiring surgery under extracorporeal circulation (ECC) and have received radiofrequency ablation (RFA) for chronic or persistent AF with a successful conversion to sinus rhythm. Patients were divided into two groups: 36 were treated with amiodarone for three months postoperatively (treatment group), and 23 had no concomitant amiodarone therapy (control group). We compared the groups regarding freedom from recurrent atrial arrhythmia and the frequency of conduction disorders requiring permanent pacemaker implantation. Results : No differences between the groups were found regarding demographic characteristics, risk profile, and heart diseases indicating cardiac surgery. During follow-up, a significantly higher proportion of patients with sinus rhythm in the group receiving amiodarone was found (80.56% vs. 52.17%; p < 0.041). No cases of premature discontinuation of amiodarone for side effects or noncompliance were registered in the treatment group. Conclusion : Three months of amiodarone therapy post-surgical RFA of AF is an effective and safe strategy for relapse prevention.
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Zheleva et al. (2023) conducted a cohort in Atrial fibrillation (n=59). Amiodarone vs. No amiodarone was evaluated on Maintenance of sinus rhythm at 3 months (p=<0.041). Three months of amiodarone therapy after surgical radiofrequency ablation significantly increased the proportion of patients maintaining sinus rhythm compared to no amiodarone (80.56% vs. 52.17%).
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