title: Antiarrhythmics after ablation of atrial fibrillation (5A Study): six-month follow-up study.
abstract: BACKGROUND
  We previously demonstrated that treatment with antiarrhythmic drugs (AADs) during the first 6 weeks after atrial fibrillation (AF) ablation reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion or hospitalization for arrhythmia management. Whether early rhythm suppression decreases longer-term arrhythmia recurrence is unknown. We now report the 6-month follow-up data from this study.
  
  
  RESULTS
  The Antiarrhythmics After Ablation of Atrial Fibrillation study prospectively randomized patients with paroxysmal AF undergoing ablation to either receive (AAD group) or not receive (no-AAD group) AAD treatment for the first 6 weeks after ablation; all patients received atrioventricular nodal blockers. Physicians were encouraged to stop the AADs after the 6-week treatment period. All patients underwent 4 weeks of transtelephonic monitoring to document asymptomatic AF and an evaluation at 6 weeks and 6 months. A total of 110 patients (71% men) aged 55±9 years were randomized, with 53 to AAD and 57 to no AAD. At 6 months, there was no difference in freedom from AF between the early AAD and no-AAD groups (38/53 [72%] versus 39/57 [68%]; P=0.84). Lack of early AF recurrence during the initial 6-week period was the only independent predictor of 6-month freedom from AF (64/76 [84%] without early recurrence versus 13/34 [38%] with early recurrence; P=0.0001).
  
  
  CONCLUSIONS
  Although short-term use of AADs after AF ablation decreases early recurrence of atrial arrhythmias, early use of AADs does not prevent arrhythmia recurrence at 6 months. Early AF recurrence on or off AADs during the initial 6-week blanking period is a strong independent predictor of long-term AF recurrence.
authors.affiliation: Cardiac Electrophysiology Section, Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Leong-Sit
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Roux
authors.forename: Erica
authors.initials: E
authors.lastname: Zado
authors.forename: David J
authors.initials: DJ
authors.lastname: Callans
authors.forename: Fermin
authors.initials: F
authors.lastname: Garcia
authors.forename: David
authors.initials: D
authors.lastname: Lin
authors.forename: Francis E
authors.initials: FE
authors.lastname: Marchlinski
authors.forename: Rupa
authors.initials: R
authors.lastname: Bala
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dixit
authors.forename: Michael
authors.initials: M
authors.lastname: Riley
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Hutchinson
authors.forename: Joshua
authors.initials: J
authors.lastname: Cooper
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Russo
authors.forename: Ralph
authors.initials: R
authors.lastname: Verdino
authors.forename: Edward P
authors.initials: EP
authors.lastname: Gerstenfeld
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055502:Secondary Prevention; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents