Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study) Six-Month Follow-Up Study

作者：Leong Sit Peter; Roux Jean Francois; Zado Erica; Callans David J; Garcia Fermin; Lin David; Marchlinski Francis E; Bala Rupa; Dixit Sanjay; Riley Michael; Hutchinson Mathew D; Cooper Joshua; Russo Andrea M; Verdino Ralph; Gerstenfeld Edward P^*

来源：Circulation-Arrhythmia and Electrophysiology, 2011, 4(1): 11-14.

DOI：10.1161/CIRCEP.110.955393

• atrial fibrillation
• ablation
• antiarrhythmia agents

Background-We previously demonstrated that treatment with antiarrhythmic drugs (AADs) during the first 6 weeks after atrial fibrillation (AF) ablation reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion or hospitalization for arrhythmia management. Whether early rhythm suppression decreases longer-term arrhythmia recurrence is unknown. We now report the 6-month follow-up data from this study.
Methods and Results-The Antiarrhythmics After Ablation of Atrial Fibrillation study prospectively randomized patients with paroxysmal AF undergoing ablation to either receive (AAD group) or not receive (no-AAD group) AAD treatment for the first 6 weeks after ablation; all patients received atrioventricular nodal blockers. Physicians were encouraged to stop the AADs after the 6-week treatment period. All patients underwent 4 weeks of transtelephonic monitoring to document asymptomatic AF and an evaluation at 6 weeks and 6 months. A total of 110 patients (71% men) aged 55 +/- 9 years were randomized, with 53 to AAD and 57 to no AAD. At 6 months, there was no difference in freedom from AF between the early AAD and no-AAD groups (38/53 [72%] versus 39/57 [68%]; P=0.84). Lack of early AF recurrence during the initial 6-week period was the only independent predictor of 6-month freedom from AF (64/76 [84%] without early recurrence versus 13/34 [38%] with early recurrence; P=0.0001).
Conclusions-Although short-term use of AADs after AF ablation decreases early recurrence of atrial arrhythmias, early use of AADs does not prevent arrhythmia recurrence at 6 months. Early AF recurrence on or off AADs during the initial 6-week blanking period is a strong independent predictor of long-term AF recurrence.

• 出版日期2011-2