Effect of Restoration of Sinus Rhythm by Extensive Antiarrhythmic Drugs in Predicting Results of Catheter Ablation of Persistent Atrial Fibrillation

• Published in: The American journal of cardiology 2010-07, Vol.106 (1), p.62-68
• Main Authors: Igarashi, Miyako, MD, Tada, Hiroshi, MD, Sekiguchi, Yukio, MD, Yamasaki, Hiro, MD, Arimoto, Takanori, MD, Kuroki, Kenji, MD, Machino, Takeshi, MD, Murakoshi, Nobuyuki, MD, Aonuma, Kazutaka, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Arrhythmia Agents - therapeutic use; Antiarythmic agents; Atrial Fibrillation - drug therapy; Atrial Fibrillation - surgery; Biological and medical sciences; Brain; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Catheter Ablation; Catheters; Combined Modality Therapy; Drug therapy; Drug Therapy, Combination; Effects; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Peptides; Pharmacology. Drug treatments; Pulmonary Veins - surgery; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2010.02.016

In patients with persistent atrial fibrillation (AF), an extensive antiarrhythmic drug (AAD) therapy using class III AADs and class I AADs might be more effective in restoring sinus rhythm than class I or III AADs alone. However, the significance and efficacy of this treatment before radiofrequency catheter ablation is unclear. The present study included 51 consecutive patients with long-lasting persistent AF (>12 months) in whom ≥2 previous AADs had failed to restore sinus rhythm (SR). Before performing extensive pulmonary vein isolation, extensive AAD therapy for >3 months was attempted. Before ablation, AF had converted to SR in 33 patients (65%; SR group) and had continued in 18 (35%; AF group). The left ventricular ejection fraction had increased (p