Year : 2017 | Volume
: 23 | Issue : 3 | Page : 125--134
Effectiveness of hybrid therapy versus radiofrequency ablation alone in decreasing recurrence after ablation of atrial fibrillation
Ahmed T Mahmoud, Mohammed M Abbas, Moataz M El-Hallag, Khaled H Mohammed, Hesham A.E Al-Aasar
Department of Critical Care Medicine, Cairo University, Cairo, Egypt
Atrial fibrillation (AF) represents an important public health problem. Catheter ablation has emerged as effective therapy. Recurrence after ablation is still around 20–40%. The long-term use of anti-arrhythmic drugs (AAD) after AF ablation has been traditionally reported to reduce late AF recurrences; but has never been supported by randomised trials.
To test if routine continuation of the previously unsuccessful AAD beyond blanking period reduces AF recurrence at one year after AF ablation.
Patients and method
This randomised controlled clinical trial was conducted between January 2013 and January 2015 in Critical Care Medicine Department – Cairo University. Patients with symptomatic, drug refractory AF were enrolled. All patients underwent pulmonary vein isolation ± left atrial ablation according to AF type. The previously unsuccessful AAD was continued for at least 3 months after ablation, after which patients were randomised to either continue or stop that drug. Patients were regularly followed up for at least additional 9 months. The primary endpoint was reduction of AF recurrence. Secondary endpoints included identification of predictors of recurrence and rate of complications.
Thirty-one patients with paroxysmal (80.6%) and persistent (19.4%) AF were enrolled. Pulmonary vein isolation was achieved in all patients. Seventeen patients were randomized to continue AAD (54.8%) beyond blanking period. After 12 months, there was no statistically significant difference of AF recurrence between the two groups (35.3% vs. 21.4%, P=0.46). The same was observed for paroxysmal AF patients (30.8% vs. 8.3%, P=0.32). Persistent AF and early AF recurrence were associated with late recurrence. Only 2 patients had major complications.
Routine continuation of previously unsuccessful AAD did not reduce AF recurrence, over a period of 12 months. Persistent AF and recurrence during blanking period were associated with later recurrence.
Ahmed T Mahmoud
Department of Critical Care Medicine, Cairo University, PO Box 11562, Cairo
|How to cite this article:|
Mahmoud AT, Abbas MM, El-Hallag MM, Mohammed KH, Al-Aasar HA. Effectiveness of hybrid therapy versus radiofrequency ablation alone in decreasing recurrence after ablation of atrial fibrillation.Kasr Al Ainy Med J 2017;23:125-134
|How to cite this URL:|
Mahmoud AT, Abbas MM, El-Hallag MM, Mohammed KH, Al-Aasar HA. Effectiveness of hybrid therapy versus radiofrequency ablation alone in decreasing recurrence after ablation of atrial fibrillation. Kasr Al Ainy Med J [serial online] 2017 [cited 2018 Jul 19 ];23:125-134
Available from: http://www.kamj.eg.net/article.asp?issn=1687-4625;year=2017;volume=23;issue=3;spage=125;epage=134;aulast=Mahmoud;type=0