| Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study). | |
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MedLine Citation:
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PMID: 19738139 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks after AF ablation would reduce the occurrence of atrial arrhythmias. METHODS AND RESULTS: We randomized consecutive patients with paroxysmal AF undergoing ablation to empirical antiarrhythmic therapy (AAD group) or no antiarrhythmic therapy (no-AAD group) for the first 6 weeks after ablation. In the no-AAD group, only atrioventricular nodal blocking agents were prescribed. All patients wore a transtelephonic monitor for 4 weeks after discharge and were reevaluated at 6 weeks. The primary end point of the study was a composite of (1) atrial arrhythmias lasting more than 24 hours; (2) atrial arrhythmias associated with severe symptoms requiring hospital admission, cardioversion, or initiation/change of antiarrhythmic drug therapy; and (3) intolerance to antiarrhythmic agent requiring drug cessation. Of 110 enrolled patients (age 55+/-9 years, 71% male), 53 were randomized to AAD and 57 to no-AAD. There was no difference in baseline characteristics between groups. During the 6 weeks after ablation, fewer patients reached the primary end point in the AAD compared with the no-AAD group (19% versus 42%; P=0.005). There remained fewer events in the AAD group (13% versus 28%; P=0.05) when only end points of AF >24 hours, arrhythmia-related hospitalization, or electrical cardioversion were compared. CONCLUSIONS: AAD treatment during the first 6 weeks after AF ablation is well tolerated and reduces the incidence of clinically significant atrial arrhythmias and need for cardioversion/hospitalization for arrhythmia management. |
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Authors:
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Jean-François Roux; Erica Zado; David J Callans; Fermin Garcia; David Lin; Francis E Marchlinski; Rupa Bala; Sanjay Dixit; Michael Riley; Andrea M Russo; Mathew D Hutchinson; Joshua Cooper; Ralph Verdino; Vickas Patel; Parijat S Joy; Edward P Gerstenfeld |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2009-09-08 |
Journal Detail:
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Title: Circulation Volume: 120 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-22 Completed Date: 2009-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1036-40 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00408200 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Arrhythmia Agents / therapeutic use* Atrial Fibrillation / surgery* Catheter Ablation* Female Humans Male Middle Aged Monitoring, Physiologic Prospective Studies Recurrence |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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