title: Antiarrhythmic therapy as an adjuvant to promote post pulmonary vein isolation success-a meta-analysis.
abstract: BACKGROUND
  Three months of empirical antiarrhythmic drug (AAD) therapy after atrial fibrillation ablation (AFA) is a common practice to prevent early arrhythmia recurrence; the data of influence of this practice on longer term ablation outcomes is limited.
  
  
  OBJECTIVE
  The aim of this study was to perform a meta-analysis of published controlled trials comparing temporary AAD therapy after AFA with no AAD therapy in patients after AFA. The primary outcome was recurrence of arrhythmia.
  
  
  RESULTS
  1Eight prospective trials were included. Among 2952 patients, 1991 (67 %) had paroxysmal AF, and 967 (32.7 %) had persistent AF. In total, 1502 patients were treated with AADs and 1450 patients served as a control group (no AAD therapy). Various class IC-III antiarrhythmics were used. Length of AAD administration varied between 6 and 12 weeks after start of AFA. The follow-up duration ranged from 1.5 to 17 months after stopping medication. Among AAD treated patients, the recurrence of arrhythmia rate was 30.69 vs. 33.79 % in control patients (odd ratio 0.86, 95 % CI 0.71-1.06, P = 0.15). In patients who received largely amiodarone, there was a trend for difference in recurrence of atrial arrhythmia (odds ratio 0.60, 95 % CI 0.34-1.09, P = 0.09).
  
  
  CONCLUSIONS
  Short-term post pulmonary vein isolation (PVI) AAD therapy does not substantially reduce overall recurrence of AF after ablation.
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. gustavogoldenberg0@gmail.com.
authors.forename: Gustavo R
authors.initials: GR
authors.lastname: Goldenberg
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Burd
authors.affiliation: Medical University of Warsaw, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lodzinski
authors.affiliation: Laboratorio di Elettrofisiologia, Casa di Cura San Michele, Maddaloni, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
authors.affiliation: Women's College Hospital, University of Toronto, Toronto, Canada.|Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Udell
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Newman
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shurrab
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.|Women's College Hospital, University of Toronto, Toronto, Canada.
authors.forename: Eugene
authors.initials: E
authors.lastname: Crystal
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000628:therapy*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Ablation; Antiarrhythmics drugs; Atrial fibrillation; Pulmonary vein isolation