Document Detail

Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study).
MedLine Citation:
PMID:  19738139     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-09-08
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-22     Completed Date:  2009-10-08     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1036-40     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / surgery*
Catheter Ablation*
Middle Aged
Monitoring, Physiologic
Prospective Studies
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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