Antiarrhythmics after ablation of atrial fibrillation (5A study)

Jean François Roux; Erica Zado; David J. Callans; Fermin Garcia; David Lin; Francis E. Marchlinski; Rupa Bala; Sanjay Dixit; Michael Riley; Andrea M. Russo; Mathew D. Hutchinson; Joshua Cooper; Ralph Verdino; Vickas Patel; Parijat S. Joy; Edward P. Gerstenfeld

doi:10.1161/CIRCULATIONAHA.108.839639

Antiarrhythmics after ablation of atrial fibrillation (5A study)

Jean François Roux
, Erica Zado
, David J. Callans
, Fermin Garcia
, David Lin
, Francis E. Marchlinski
, Rupa Bala
, Sanjay Dixit
, Michael Riley
, Andrea M. Russo
, Mathew D. Hutchinson
, Joshua Cooper
, Ralph Verdino
, Vickas Patel
, Parijat S. Joy
, Edward P. Gerstenfeld

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND-: Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks after AF ablation would reduce the occurrence of atrial arrhythmias. METHODS AND RESULTS-: We randomized consecutive patients with paroxysmal AF undergoing ablation to empirical antiarrhythmic therapy (AAD group) or no antiarrhythmic therapy (no-AAD group) for the first 6 weeks after ablation. In the no-AAD group, only atrioventricular nodal blocking agents were prescribed. All patients wore a transtelephonic monitor for 4 weeks after discharge and were reevaluated at 6 weeks. The primary end point of the study was a composite of (1) atrial arrhythmias lasting more than 24 hours; (2) atrial arrhythmias associated with severe symptoms requiring hospital admission, cardioversion, or initiation/change of antiarrhythmic drug therapy; and (3) intolerance to antiarrhythmic agent requiring drug cessation. Of 110 enrolled patients (age 55±9 years, 71% male), 53 were randomized to AAD and 57 to no-AAD. There was no difference in baseline characteristics between groups. During the 6 weeks after ablation, fewer patients reached the primary end point in the AAD compared with the no-AAD group (19% versus 42%; P=0.005). There remained fewer events in the AAD group (13% versus 28%; P=0.05) when only end points of AF >24 hours, arrhythmia-related hospitalization, or electrical cardioversion were compared. CONCLUSIONS-: AAD treatment during the first 6 weeks after AF ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion/hospitalization for arrhythmia management.

Original language	English (US)
Pages (from-to)	1036-1040
Number of pages	5
Journal	Circulation
Volume	120
Issue number	12
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.108.839639
State	Published - Sep 2009
Externally published	Yes

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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10.1161/CIRCULATIONAHA.108.839639

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Roux, J. F., Zado, E., Callans, D. J., Garcia, F., Lin, D., Marchlinski, F. E., Bala, R., Dixit, S., Riley, M., Russo, A. M., Hutchinson, M. D., Cooper, J., Verdino, R., Patel, V., Joy, P. S., & Gerstenfeld, E. P. (2009). Antiarrhythmics after ablation of atrial fibrillation (5A study). Circulation, 120(12), 1036-1040. https://doi.org/10.1161/CIRCULATIONAHA.108.839639

@article{561b51e2af20436e89b22c089c81627c,

title = "Antiarrhythmics after ablation of atrial fibrillation (5A study)",

abstract = "BACKGROUND-: Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks after AF ablation would reduce the occurrence of atrial arrhythmias. METHODS AND RESULTS-: We randomized consecutive patients with paroxysmal AF undergoing ablation to empirical antiarrhythmic therapy (AAD group) or no antiarrhythmic therapy (no-AAD group) for the first 6 weeks after ablation. In the no-AAD group, only atrioventricular nodal blocking agents were prescribed. All patients wore a transtelephonic monitor for 4 weeks after discharge and were reevaluated at 6 weeks. The primary end point of the study was a composite of (1) atrial arrhythmias lasting more than 24 hours; (2) atrial arrhythmias associated with severe symptoms requiring hospital admission, cardioversion, or initiation/change of antiarrhythmic drug therapy; and (3) intolerance to antiarrhythmic agent requiring drug cessation. Of 110 enrolled patients (age 55±9 years, 71\% male), 53 were randomized to AAD and 57 to no-AAD. There was no difference in baseline characteristics between groups. During the 6 weeks after ablation, fewer patients reached the primary end point in the AAD compared with the no-AAD group (19\% versus 42\%; P=0.005). There remained fewer events in the AAD group (13\% versus 28\%; P=0.05) when only end points of AF >24 hours, arrhythmia-related hospitalization, or electrical cardioversion were compared. CONCLUSIONS-: AAD treatment during the first 6 weeks after AF ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion/hospitalization for arrhythmia management.",

author = "Roux, \{Jean Fran{\c c}ois\} and Erica Zado and Callans, \{David J.\} and Fermin Garcia and David Lin and Marchlinski, \{Francis E.\} and Rupa Bala and Sanjay Dixit and Michael Riley and Russo, \{Andrea M.\} and Hutchinson, \{Mathew D.\} and Joshua Cooper and Ralph Verdino and Vickas Patel and Joy, \{Parijat S.\} and Gerstenfeld, \{Edward P.\}",

year = "2009",

month = sep,

doi = "10.1161/CIRCULATIONAHA.108.839639",

language = "English (US)",

volume = "120",

pages = "1036--1040",

journal = "Circulation",

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TY - JOUR

T1 - Antiarrhythmics after ablation of atrial fibrillation (5A study)

AU - Roux, Jean François

AU - Zado, Erica

AU - Callans, David J.

AU - Garcia, Fermin

AU - Lin, David

AU - Marchlinski, Francis E.

AU - Bala, Rupa

AU - Dixit, Sanjay

AU - Riley, Michael

AU - Russo, Andrea M.

AU - Hutchinson, Mathew D.

AU - Cooper, Joshua

AU - Verdino, Ralph

AU - Patel, Vickas

AU - Joy, Parijat S.

AU - Gerstenfeld, Edward P.

PY - 2009/9

Y1 - 2009/9

N2 - BACKGROUND-: Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks after AF ablation would reduce the occurrence of atrial arrhythmias. METHODS AND RESULTS-: We randomized consecutive patients with paroxysmal AF undergoing ablation to empirical antiarrhythmic therapy (AAD group) or no antiarrhythmic therapy (no-AAD group) for the first 6 weeks after ablation. In the no-AAD group, only atrioventricular nodal blocking agents were prescribed. All patients wore a transtelephonic monitor for 4 weeks after discharge and were reevaluated at 6 weeks. The primary end point of the study was a composite of (1) atrial arrhythmias lasting more than 24 hours; (2) atrial arrhythmias associated with severe symptoms requiring hospital admission, cardioversion, or initiation/change of antiarrhythmic drug therapy; and (3) intolerance to antiarrhythmic agent requiring drug cessation. Of 110 enrolled patients (age 55±9 years, 71% male), 53 were randomized to AAD and 57 to no-AAD. There was no difference in baseline characteristics between groups. During the 6 weeks after ablation, fewer patients reached the primary end point in the AAD compared with the no-AAD group (19% versus 42%; P=0.005). There remained fewer events in the AAD group (13% versus 28%; P=0.05) when only end points of AF >24 hours, arrhythmia-related hospitalization, or electrical cardioversion were compared. CONCLUSIONS-: AAD treatment during the first 6 weeks after AF ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion/hospitalization for arrhythmia management.

AB - BACKGROUND-: Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks after AF ablation would reduce the occurrence of atrial arrhythmias. METHODS AND RESULTS-: We randomized consecutive patients with paroxysmal AF undergoing ablation to empirical antiarrhythmic therapy (AAD group) or no antiarrhythmic therapy (no-AAD group) for the first 6 weeks after ablation. In the no-AAD group, only atrioventricular nodal blocking agents were prescribed. All patients wore a transtelephonic monitor for 4 weeks after discharge and were reevaluated at 6 weeks. The primary end point of the study was a composite of (1) atrial arrhythmias lasting more than 24 hours; (2) atrial arrhythmias associated with severe symptoms requiring hospital admission, cardioversion, or initiation/change of antiarrhythmic drug therapy; and (3) intolerance to antiarrhythmic agent requiring drug cessation. Of 110 enrolled patients (age 55±9 years, 71% male), 53 were randomized to AAD and 57 to no-AAD. There was no difference in baseline characteristics between groups. During the 6 weeks after ablation, fewer patients reached the primary end point in the AAD compared with the no-AAD group (19% versus 42%; P=0.005). There remained fewer events in the AAD group (13% versus 28%; P=0.05) when only end points of AF >24 hours, arrhythmia-related hospitalization, or electrical cardioversion were compared. CONCLUSIONS-: AAD treatment during the first 6 weeks after AF ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion/hospitalization for arrhythmia management.

UR - https://www.scopus.com/pages/publications/70349673322

UR - https://www.scopus.com/pages/publications/70349673322#tab=citedBy

U2 - 10.1161/CIRCULATIONAHA.108.839639

DO - 10.1161/CIRCULATIONAHA.108.839639

M3 - Article

C2 - 19738139

SN - 0009-7322

VL - 120

SP - 1036

EP - 1040

JO - Circulation

JF - Circulation

IS - 12

ER -

Antiarrhythmics after ablation of atrial fibrillation (5A study)

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