Stine Darkner1, Xu Chen2, Jim Hansen3, Steen Pehrson2, Arne Johannessen3, Jonas Bille Nielsen2, Jesper Hastrup Svendsen4. 1. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark stine.darkner.01@regionh.dk. 2. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark. 3. Department of Cardiology, Gentofte Hospital, Copenhagen University Hospital, Gentofte, Denmark. 4. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark The Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
AIMS: Patients undergoingcatheter ablation for atrial fibrillation (AF) often experience recurrent arrhythmias within the first few months post-ablation. We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce later recurrence. METHODS AND RESULTS: In a two-centre, randomized, double-blind, placebo-controlled study, we randomized a total of 212 patients undergoing AF ablation. Patients were stratified according to type of AF (paroxysmal/persistent) and history of previous AF ablation and randomly assigned to 8 weeks of oral amiodarone therapy or matched placebo following catheter ablation. Patients were followed for 6 months. Analyses were performed according to the intention-to-treat principle. Of 212 enrolled patients [median age 61 (inter-quartile range 54-66), 83% male, 50% paroxysmal, 29% with history of previous ablation], 206 patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting >30 s following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group vs. 48/99 (48%) in the placebo group (P = 0.18). Among the secondary end-points, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations [rate ratio = 0.43; 95% confidence interval (CI) = 0.23-0.77, P = 0.006] and cardioversions (rate ratio = 0.36; 95% CI = 0.20-0.62, P = 0.0004) within the blanking period. CONCLUSION: Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period. Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
AIMS: Patients undergoing catheter ablation for atrial fibrillation (AF) often experience recurrent arrhythmias within the first few months post-ablation. We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce later recurrence. METHODS AND RESULTS: In a two-centre, randomized, double-blind, placebo-controlled study, we randomized a total of 212 patients undergoing AF ablation. Patients were stratified according to type of AF (paroxysmal/persistent) and history of previous AF ablation and randomly assigned to 8 weeks of oral amiodarone therapy or matched placebo following catheter ablation. Patients were followed for 6 months. Analyses were performed according to the intention-to-treat principle. Of 212 enrolled patients [median age 61 (inter-quartile range 54-66), 83% male, 50% paroxysmal, 29% with history of previous ablation], 206 patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting >30 s following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group vs. 48/99 (48%) in the placebo group (P = 0.18). Among the secondary end-points, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations [rate ratio = 0.43; 95% confidence interval (CI) = 0.23-0.77, P = 0.006] and cardioversions (rate ratio = 0.36; 95% CI = 0.20-0.62, P = 0.0004) within the blanking period. CONCLUSION: Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Gustavo R Goldenberg; Daniel Burd; Piotr Lodzinski; Giuseppe Stabile; Jacob A Udell; David Newman; Mohammed Shurrab; Eugene Crystal Journal: J Interv Card Electrophysiol Date: 2016-06-29 Impact factor: 1.900
Authors: Liang-Han Ling; Peter M Kistler; Jonathan M Kalman; Richard J Schilling; Ross J Hunter Journal: Nat Rev Cardiol Date: 2015-12-10 Impact factor: 32.419
Authors: Bruno Reissmann; Günter Breithardt; A John Camm; Isabelle C Van Gelder; Andreas Metzner; Paulus Kirchhof Journal: Europace Date: 2021-04-10 Impact factor: 5.214