An Aggressive Strategy for Maintenance of Sinus Rhythm Including a Combination of Catheter Ablation and Antiarrhythmic Drug Therapy Benefits Patients with Chronic Atrial Fibrillation

• Published in: Journal of Arrhythmia 2009, Vol.25 (2), p.63-69
• Main Authors: Tetsuya Haruna, Shigeru Ikeguchi, Shinsaku Takeda, Naoki Amaya, Tatsuhiko Hata, Masaharu Okada, Kunihiko Kosuga
• Format: Article
• Language: Japanese
• ISSN: 1880-4276

The effects of restoration and maintenance of sinus rhythm by a combination of catheter ablation and antiarrhythmic drugs (AADs) on atrial function in patients with chronic atrial fibrillation (AF) remain unknown. In 15 patients with chronic AF (>1 year), we attempted to restore and maintain sinus rhythm by ablation targeting complex fractionated atrial electrocardiograms (CFAEs) combined with pulmonary vein isolation with or without AADs. Sinus rhythm was restored in all patients. At 17.7 ± 7.2 months after AF ablation, maintenance of sinus rhythm was achieved in 20% of patients without AADs and in 73.3% of patients with AADs. The left atrial diameter decreased significantly by 9.5 ± 8.1% (P < 0.05) during the 12-month followup. AADs did not have any adverse effects. The aggressive strategy for maintenance of sinus rhythm involving AF ablation and AADs potentially led to recovery of structural changes in the LA in patients with chronic AF. [Introduction]Atrial fibrillation (AF) tends to be a chronic condition, and thereby potentially leads to functional and structural changes in both atria 1-7).