Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.

<h4>Purpose</h4>To evaluate if specific AADs prescribed in the blanking period (BP) after catheter ablation of atrial fibrillation (AF) may be associated with reduced risk of early recurrence (ER) and/or late recurrence (LR) of atrial arrhythmias.<h4>Methods</h4>A total of 47...

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Autores principales:	Chaitanya L Malladi, Douglas Darden, Omar Aldaas, Praneet S Mylavarapu, Michael Eskander, Florentino Lupercio, Frederick T Han, Kurt S Hoffmayer, Farshad Raissi, Gordon Ho, David Krummen, Gregory K Feld, Jonathan C Hsu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2a46519650654f32bd57513cbfa09891
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spelling	oai:doaj.org-article:2a46519650654f32bd57513cbfa098912021-12-02T20:10:10ZAssociation between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.1932-620310.1371/journal.pone.0253266https://doaj.org/article/2a46519650654f32bd57513cbfa098912021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253266https://doaj.org/toc/1932-6203<h4>Purpose</h4>To evaluate if specific AADs prescribed in the blanking period (BP) after catheter ablation of atrial fibrillation (AF) may be associated with reduced risk of early recurrence (ER) and/or late recurrence (LR) of atrial arrhythmias.<h4>Methods</h4>A total of 478 patients undergoing first-time ablation at a single institution were included. Outcomes were: ER, LR, discontinuation of AAD less than 90 days post-ablation, and second ablation. ER was defined as AF, atrial flutter (AFL), or atrial tachycardia (AT) > 30 seconds within BP. LR was defined as AF/AFL/AT > 30 seconds after BP.<h4>Results</h4>Of 478 patients, 14.9% were prescribed no AAD, 26.4% propafenone/flecainide, 34.5% sotalol/dofetilide, 10.7% dronedarone, and 13.6% amiodarone. Patients prescribed amiodarone were more likely to have persistent AF, hypertension, diabetes, and other comorbidities. In unadjusted analyses, there were no differences between groups in relation to ER (log rank P = 0.171), discontinuation of AAD before ninety days post-ablation (log rank P = 0.235), or freedom from second ablation (log rank P = 0.147). After multivariable adjustment, patients prescribed amiodarone or dronedarone were more likely to experience LR than those prescribed no AAD [Adjusted Hazard Ratio (AHR) 1.83, 95% CI 1.10-3.04, p = 0.02; AHR 1.79, 95% CI 1.05-3.05, p = 0.03, respectively].<h4>Conclusion</h4>Following first-time catheter ablation, there were no differences between specific AAD prescription and risk of ER, while those prescribed amiodarone or dronedarone in the BP were more likely to experience LR than those prescribed no AAD, which may represent an association due to confounding by indication.Chaitanya L MalladiDouglas DardenOmar AldaasPraneet S MylavarapuMichael EskanderFlorentino LupercioFrederick T HanKurt S HoffmayerFarshad RaissiGordon HoDavid KrummenGregory K FeldJonathan C HsuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253266 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chaitanya L Malladi Douglas Darden Omar Aldaas Praneet S Mylavarapu Michael Eskander Florentino Lupercio Frederick T Han Kurt S Hoffmayer Farshad Raissi Gordon Ho David Krummen Gregory K Feld Jonathan C Hsu Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
description	<h4>Purpose</h4>To evaluate if specific AADs prescribed in the blanking period (BP) after catheter ablation of atrial fibrillation (AF) may be associated with reduced risk of early recurrence (ER) and/or late recurrence (LR) of atrial arrhythmias.<h4>Methods</h4>A total of 478 patients undergoing first-time ablation at a single institution were included. Outcomes were: ER, LR, discontinuation of AAD less than 90 days post-ablation, and second ablation. ER was defined as AF, atrial flutter (AFL), or atrial tachycardia (AT) > 30 seconds within BP. LR was defined as AF/AFL/AT > 30 seconds after BP.<h4>Results</h4>Of 478 patients, 14.9% were prescribed no AAD, 26.4% propafenone/flecainide, 34.5% sotalol/dofetilide, 10.7% dronedarone, and 13.6% amiodarone. Patients prescribed amiodarone were more likely to have persistent AF, hypertension, diabetes, and other comorbidities. In unadjusted analyses, there were no differences between groups in relation to ER (log rank P = 0.171), discontinuation of AAD before ninety days post-ablation (log rank P = 0.235), or freedom from second ablation (log rank P = 0.147). After multivariable adjustment, patients prescribed amiodarone or dronedarone were more likely to experience LR than those prescribed no AAD [Adjusted Hazard Ratio (AHR) 1.83, 95% CI 1.10-3.04, p = 0.02; AHR 1.79, 95% CI 1.05-3.05, p = 0.03, respectively].<h4>Conclusion</h4>Following first-time catheter ablation, there were no differences between specific AAD prescription and risk of ER, while those prescribed amiodarone or dronedarone in the BP were more likely to experience LR than those prescribed no AAD, which may represent an association due to confounding by indication.
format	article
author	Chaitanya L Malladi Douglas Darden Omar Aldaas Praneet S Mylavarapu Michael Eskander Florentino Lupercio Frederick T Han Kurt S Hoffmayer Farshad Raissi Gordon Ho David Krummen Gregory K Feld Jonathan C Hsu
author_facet	Chaitanya L Malladi Douglas Darden Omar Aldaas Praneet S Mylavarapu Michael Eskander Florentino Lupercio Frederick T Han Kurt S Hoffmayer Farshad Raissi Gordon Ho David Krummen Gregory K Feld Jonathan C Hsu
author_sort	Chaitanya L Malladi
title	Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
title_short	Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
title_full	Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
title_fullStr	Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
title_full_unstemmed	Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
title_sort	association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2a46519650654f32bd57513cbfa09891
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Association between specific antiarrhythmic drug prescription in the post-procedural blanking period and recurrent atrial arrhythmias after catheter ablation for atrial fibrillation.

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