title: Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial.
abstract: OBJECTIVE
  Substantial portion of early arrhythmia recurrence after catheter ablation for atrial fibrillation (AF) is considered to be due to irritability in left atrium (LA) from the ablation procedure. We sought to evaluate whether 90-day use of antiarrhythmic drug (AAD) following AF ablation could reduce the incidence of early arrhythmia recurrence and thereby promote reverse remodelling of LA, leading to improved long-term clinical outcomes.
  
  
  RESULTS
  A total of 2038 patients who had undergone radiofrequency catheter ablation for paroxysmal, persistent, or long-lasting AF were randomly assigned to either 90-day use of Vaughan Williams class I or III AAD (1016 patients) or control (1022 patients) group. The primary endpoint was recurrent atrial tachyarrhythmias lasting for >30 s or those requiring repeat ablation, hospital admission, or usage of class I or III AAD at 1 year, following the treatment period of 90 days post ablation. Patients assigned to AAD were associated with significantly higher event-free rate from recurrent atrial tachyarrhythmias when compared with the control group during the treatment period of 90 days [59.0 and 52.1%, respectively; adjusted hazard ratio (HR) 0.84; 95% confidence interval (CI) 0.73-0.96; P = 0.01]. However, there was no significant difference in the 1-year event-free rates from the primary endpoint between the groups (69.5 and 67.8%, respectively; adjusted HR 0.93; 95% CI 0.79-1.09; P = 0.38).
  
  
  CONCLUSIONS
  Short-term use of AAD for 90 days following AF ablation reduced the incidence of recurrent atrial tachyarrhythmias during the treatment period, but it did not lead to improved clinical outcomes at the later phase.
authors.affiliation: Division of Cardiology, Tenri Hospital, Tenri, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kaitani
authors.affiliation: Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kobori
authors.affiliation: Heart Rhythm Center, Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakazawa
authors.affiliation: Heart Rhythm Center, Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Cardiovascular Center, Shiroyama Hospital, Habikino City, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kurotobi
authors.affiliation: Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Itsuro
authors.initials: I
authors.lastname: Morishima
authors.affiliation: Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
authors.forename: Fumiharu
authors.initials: F
authors.lastname: Miura
authors.affiliation: Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Masuda
authors.affiliation: Department of Cardiovascular Medicine, Nara Prefecture Western Medical Center, Nara, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Naito
authors.affiliation: Department of Cardiovascular Medicine, Nara Prefecture Western Medical Center, Nara, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Fujimoto
authors.affiliation: First Department of Internal Medicine, Nara Medical University, Nara, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Division of Cardiology, Osaka General Medical Center, Osaka, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Furukawa
authors.affiliation: Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.affiliation: Department of Cardiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Himeji Cardiovascular Center, Himeji, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Okajima
authors.affiliation: Department of Cardiovascular Medicine, Okamura Memorial Hospital, Shizuoka, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Yao
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Egami
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Noda
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Miyamoto
authors.affiliation: Cardiovascular Center, Tazuke Medical Research Institute Kitano Hospital, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Haruna
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Tetsuma
authors.initials: T
authors.lastname: Kawaji
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshizawa
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Toyota
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Yahata
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sugiyama
authors.affiliation: Department of Cardiovascular Medicine, Okamura Memorial Hospital, Shizuoka, Japan.
authors.forename: Yukei
authors.initials: Y
authors.lastname: Higashi
authors.affiliation: Heart Rhythm Center, Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.affiliation: Heart Rhythm Center, Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Horie
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kengo F
authors.initials: KF
authors.lastname: Kusano
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
authors.affiliation: Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan shizuta@kuhp.kyoto-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shizuta
mesh_terms: D000359:Aftercare; D000368:Aged; D000553:Ambulatory Care; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D018572:Disease-Free Survival; D015716:Electrocardiography, Ambulatory; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Antiarrhythmic drug; Atrial fibrillation; Catheter ablation; Reverse remodelling