Extensive antiarrhythmic drugs after catheter ablation of persistent atrial fibrillation

Objective Whether early rhythm suppression with extensive antiarrhythmic drugs (AADs) in persistent atrial fibrillation (AF) after catheter ablation decreases arrhythmia recurrence is unknown. We now report the 12-month follow-up data in this prospective and randomized study. Methods and results 123 consecutive patients with persistent AF undergoing catheter ablation were randomly divided into an extensive AADs therapy group (group 1:62 patients using both class lc and III AADs) or one AAD therapy group (group 2:61 patients using class lc or III AADs alone) for the initial 2 months after ablation. Recurrence of atrial tachyarrhythmias (Ala) was valuated at both 2 months and 12 months following ablation. During the first 2 months after ablation, less ATa were found in group 1 compared with group 2(17/62 versus 29/61, P=0.021). However, there was no difference with regard to Ala at 12 months between the groups (21/62 versus 22/61, P=0.799). Ala at 2 months and left atrial diameter (LAD) were the statistically significant predictors of Ala during 12-month follow-up. Conclusions While use of extensive AADs within the initial 2 months after persistent AF ablation decreases early Ala, it does not prevent late Ala. Moreover, LAD as well as early Ala is a strong predictor of Ala at 12 months.