title: Antiarrhythmic drug therapy after radiofrequency catheter ablation in patients with atrial fibrillation.
abstract: OBJECTIVE
  The use of antiarrhythmic drugs after ablation is a controversial issue when evaluating the efficacy of atrial fibrillation (AF) ablation. This study compares in a prospective and randomized fashion the impact of an antiarrhythmic drug in preventing AF recurrence after AF ablation.
  
  
  METHODS
  From February 2004 to May 2005, 107 consecutive patients (mean age 57 +/- 10 years, 69 men), with paroxysmal (60%) or persistent (40%) drug refractory AF, were randomly assigned to ablation alone (Group A, 53 patients) or combined with the best antiarrhythmic therapy, preferably amiodarone (Group B, 54 patients). All patients underwent cavo-tricuspid and left inferior pulmonary vein (PV)-mitral isthmus ablation plus circumferential PV ablation, using a guided electro-anatomical approach. Standard electrocardiograms (ECG), and ambulatory and transtelephonic ECG monitoring were used to assess AF recurrences. Recurrences during the first month after ablation were excluded from this analysis.
  
  
  RESULTS
  At 12 months of follow-up, no significant difference was observed in the rates of AF recurrences between Group A (18/53 patients, 34%) and Group B (16/54 patients, 30%). The percentage of patients with >/= 1 asymptomatic AF episode was higher in Group B than in Group A (10/16 patients, 63%, vs 5/18 patients, 28%, P = 0.04).
  
  
  CONCLUSIONS
  Continuing antiarrhythmic drug therapy in patients who undergo catheter ablation for AF did not lower the rate of AF recurrences. Antiarrhythmic drugs increased the proportion of patients with asymptomatic AF episodes.
authors.affiliation: Casa di Cura S. Michele, Maddaloni (CE), Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Turco
authors.forename: Antonio
authors.initials: A
authors.lastname: De Simone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Rocca
authors.forename: Assunta
authors.initials: A
authors.lastname: Iuliano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Capuano
authors.forename: Costantino
authors.initials: C
authors.lastname: Astarita
authors.forename: Tommaso
authors.initials: T
authors.lastname: Di Napoli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Messina
authors.forename: Silvano
authors.initials: S
authors.lastname: Baldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000517:prevention & control / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone