Why the study?
Does the addition of class I or III antiarrhythmic drugs to rate control reduce the recurrence of atrial fibrillation at 6 weeks in patients who develop paroxysmal AF after CABG surgery?
Does the addition of class I or III antiarrhythmic drugs to rate control reduce the recurrence of atrial fibrillation at 6 weeks in patients who develop paroxysmal AF after CABG surgery?
Paroxysmal atrial fibrillation after CABG surgery appears to be a self-limited process, and the addition of class I or III antiarrhythmic drugs to rate control does not provide additional benefit for maintaining sinus rhythm at 6 weeks.
Answers are grounded in this paper and cite their sources.
Supports rate control alone for post-CABG paroxysmal AF; leaves open antiarrhythmic benefit in randomized trials.
This was a retrospective analysis of patients who had CABG surgery at our hospital over a 12-month period to determine the intermediate-term prognosis of those who had developed PAF after their operation before hospital discharge. Of 317 patients who were operated by a single surgical group, 116 (37%) had AF postoperatively of whom 112 had the paroxysmal form. Of these, 36 were treated with class I or III antiarrhythmic drugs and rate control drugs (group 1) and 76 were treated with rate control alone (group 2). Group 3 consisted of 151 randomly selected patients who did not have AF. All patients were reevaluated at 6 weeks to determine their rhythm and clinical status. Only one patient each in groups 1 and 2 was in AF 6 weeks after discharge. There was a trend toward a higher mortality and morbidity in group 2 patients. PAF after coronary surgery appears to be a self-limited disease process. In this cohort of patients, the rate of recurrence of AF after discharge was similar in patients receiving class I or class III antiarrhythmic drugs together with rate control agents compared to those receiving rate control drugs alone.
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Kowey et al. (2001) studied this question.
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