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Recurrence of arrhythmia following short-term oral AMIOdarone after CATheter ablation for atrial fibrillation: A double-blind, randomized, placebo-controlled study

ESC Congress 2014 - Hot Line report




By Stine Darkner, (Copenhagen, Denmark)
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List of Authors:
Stine Darkner, MD, Xu Chen, MD, DMSci, Jim Hansen, MD, DMSci, Steen Pehrson, MD, DMSci, Arne Johannessen, MD, DMSci, Jonas B Nielsen, MD, Jesper Hastrup Svendsen, MD, DMSci


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.
In a 2-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 [IQR 54-66], 83% male, 50% paroxysmal, 29% with history of previous ablation), 206 patients were available for analysis of the primary endpoint which was any documented atrial tachyarrhythmia lasting >30 seconds following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group versus 48/99 (48%) in the placebo group (p=0.18). Among the secondary endpoints, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia related hospitalizations (rate ratio=0.43; 95% 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.
Short term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at 6 months follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period.


By Karl-Heinz Kuck, FESC (Hamburg, Germany)
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Hot Line: Coronary artery disease and atrial fibrillation

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.