title: Recurrence of arrhythmia following short-term oral AMIOdarone after CATheter ablation for atrial fibrillation: a double-blind, randomized, placebo-controlled study (AMIO-CAT trial).
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  In a two-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 (inter-quartile range 54-66), 83% male, 50% paroxysmal, 29% with history of previous ablation], 206 patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting >30 s following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group vs. 48/99 (48%) in the placebo group (P = 0.18). Among the secondary end-points, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations [rate ratio = 0.43; 95% confidence interval (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.
  
  
  CONCLUSIONS
  Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period.
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark stine.darkner.01@regionh.dk.
authors.forename: Stine
authors.initials: S
authors.lastname: Darkner
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark.
authors.forename: Xu
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Gentofte Hospital, Copenhagen University Hospital, Gentofte, Denmark.
authors.forename: Jim
authors.initials: J
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Pehrson
authors.affiliation: Department of Cardiology, Gentofte Hospital, Copenhagen University Hospital, Gentofte, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Johannessen
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark.
authors.forename: Jonas Bille
authors.initials: JB
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Section 2013, Blegdamsvej 9, Copenhagen DK-2100, Denmark The Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013610:Tachycardia / Q000209:etiology*
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Ablation; Antiarrhythmic drugs; Atrial fibrillation